Replacing half of HbA1c follow-up appointments for people with type 2 diabetes with self-monitoring and electronic feedback reduces healthcare costs especially in rural areas, a study has suggested.
Researchers from the University of Eastern Finland say that self-measurements and electronic feedback can reduce annual total costs of HbA1c testing by almost 60%.
The Finland researchers believe their model could be used to reduce health costs within UK diabetes care, and help people with type 2 diabetes avoid travel costs from attending follow-up visits.
The cost reduction was achieved by swapping half of follow-up appointments with a healthcare professional. The costs went down from 280 euros to 120 per person, according to the research.
“More emphasis should be laid on the development of mobile and internet technologies in self-monitoring, electronic feedback and consultancy systems,” said the researchers.
“The technological capabilities of mobile technologies have advanced at a high pace and the popularity and ownership of handheld devices such as smartphones and tablet PCs has increased.”
The research took place in the North Karelia region of Finland. The analysis involved using a geographic information systems (GIS) together with patient registers totalling 9,070 people with type 2 diabetes.
A ‘georeferenced’ cost model was then used to analyse accessibility of care and the costs associated with HbA1c follow-up appointments. The analysis factored in how people travelled to appointments either by walking, on a bike, driving or using a bus or taxi.
Travel costs for the person with diabetes were reduced from an average of 45 euros to 17, according to the study.
Dr Aapeli Lemine, from the study, said: “The societal cost-efficiency of type 2 diabetes care could be improved in by taking into consideration not only the direct costs of [HbA1c] monitoring, but also the indirect costs, such as patients’ travel costs.”
Both the costs of travel and time equated to 21% of the total expense of HbA1c monitoring, the study found.
Dr Leminen said using GIS along with patient registers has the potential to provide insights beyond diabetes care. He said: “This cost model we’ve now tested in the eastern part of Finland can easily be used in other places as well to calculate the costs of different diseases, such as cancer and cardiovascular diseases.”
The research was published by the International Journal of Medical Informatics.

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