This research explores the cost, life expectancy and quality of life impact of a national quarterly monitoring program on type 2 diabetes for non-insulin-dependent patients. In Ukraine, many people suffer from diabetes and its complications. In this research we focus only on type 2 diabetes, as the most common type of diabetes. Among those we focus only on non-insulin-dependent patients, as these are the patients that would benefit the most from the improved monitoring. Diabetes leads to lower life expectancy, lower quality of life of an individual, and higher healthcare costs both for people and the healthcare system. This burden increases even more if diabetes is not managed. The research analyses the potential impact of a nationwide point of care based non-insulin-dependent diabetics monitoring program.
The research method used in the study is the combined cost-effectiveness analysis and budget impact analysis from the payer perspective. This is a special type of the summative evaluation research used to assess the impact of a healthcare program. With the research method, the author answers the question whether the proposed diabetes monitoring strategy is more cost-effective than the standard of care. The author also answers the question what the impact of a nation-wide diabetes monitoring program on the annual healthcare budget of the payer would be. He also analyses the average cost associated with diabetes during the lifetime of an average patient from the payer perspective; the impact on the quality of life of such a patient, and on her (his) life expectancy. All this provides important information to assess the impact of an alternative healthcare economic policy for diabetes. Two formal decision scientific models were developed. They model the situation of diabetics with quarterly point of care based HbA1c monitoring program and compare it with the standard of care. The main types of input data for the models are transition probabilities between different health states, cost and utility of each individual health state. The data used in the models were taken from the literature review of publications and discussions with healthcare professionals in Ukraine.
Table of Contents
1 Introduction
2 Background
2.1 Diabetes
2.2 Type 2 diabetes mellitus – a largely preventable disease
2.3 Diabetes – burden of disease
2.4 Diabetes monitoring and treatment
2.5 Diabetes monitoring guidelines in Ukraine
3 Literature review on cost-effectiveness analysis and budget impact analysis
3.1 Budget Impact Analysis
3.2 Cost-effectiveness analysis
3.3 Markov modeling
4 Budget impact analysis of a nation-wide quarterly POC-based type 2 diabetes mellitus monitoring program
4.1 Research methodology
4.2 Research setting and data collection
4.3 Findings
4.4 Limitations
5 Cost-effectivness analysis of the nation-wide quarterly POC-based diabetes mellitus monotoring policy for type 2 diabetes
5.1 Methodology and research design
5.2 Research setting and data collection
5.3 Findings
5.4 Sensitivity Analysis
5.5 Value of Information
6 Conclusion
6.1 Limitations
6.2 Substantative conclusions and final recommendations
6.3 Practical contributions of the study
6.4 Suggestions for future research
Research Objectives and Focus
This research evaluates the health and economic impacts of implementing a national quarterly point-of-care HbA1c monitoring program for non-insulin-dependent type 2 diabetes patients in Ukraine, aiming to determine if such a policy is more cost-effective than the existing standard of care.
- Economic evaluation (cost-effectiveness and budget impact) of diabetes monitoring strategies.
- Clinical impact of improved glycaemic control on life expectancy and quality of life.
- Integration of point-of-care (POC) testing within primary healthcare settings in Ukraine.
- Comparison of standard laboratory-based monitoring versus quarterly POC-based monitoring.
- Sensitivity analysis of economic outcomes based on varying threshold assumptions.
Excerpt from the Book
2.1 Diabetes
Diabetes is one of the four major global non-communicable diseases identified by WHO along with cardiovascular disease, cancer and chronic respiratory disease. Besides, diabetes is a personal and social calamity. It imposes high burden on inviduals, their families and economies worldwide. It is a chronic condition, which occurs when the body either cannot produce or cannot use insulin.
Next, we give an overview on what is insulin. Insulin is a hormone produced in pancreas. Insulin helps the human body both to store and to tranform glucose into energy. In the human body the process starts after a human consumes food. After the food consumption, the surgar or carbohydrates from the food are converted into glucose by a human body and injected in the blood. When the human body detects high level of glucose in blood, it reacts by triggering the pancreas to release insulin into the bloodstream. The function of insulin is not to flight the glucose. The human body needs glucose as an energy source to support all its functions. The function of insulin is to travel to the cells and tell them to open up and let the glucose in. As a next step, the human cells process glucose and either directly convert it into energy or store it for later use. The Figure 1 shows the process of absorption of glucose by human cells with the help of insulin.
Summary of Chapters
1 Introduction: Provides an overview of the diabetes burden, sets the scope for type 2 diabetes, and defines the research question regarding optimal monitoring policy in Ukraine.
2 Background: Discusses the disease progression of diabetes, associated complications, current monitoring practices, and the role of lifestyle interventions.
3 Literature review on cost-effectiveness analysis and budget impact analysis: Explores the scientific methods for performing economic evaluations and Markov modeling in healthcare.
4 Budget impact analysis of a nation-wide quarterly POC-based type 2 diabetes mellitus monitoring program: Details the research methodology and findings regarding the budgetary consequences of the proposed monitoring program in Ukraine.
5 Cost-effectivness analysis of the nation-wide quarterly POC-based diabetes mellitus monotoring policy for type 2 diabetes: Evaluates the cost-effectiveness, sensitivity, and information value of different monitoring policies using Markov models.
6 Conclusion: Summarizes the study’s findings, addresses limitations, and suggests future research directions and practical healthcare policy recommendations.
Keywords
Diabetes, Type 2 Diabetes Mellitus, HbA1c, Point-of-Care Testing, Cost-Effectiveness Analysis, Budget Impact Analysis, Ukraine, Healthcare Economic Policy, Glycaemic Control, Markov Modeling, Health Outcomes, Quality of Life, Preventive Treatment, Sensitivity Analysis, Value of Information.
Frequently Asked Questions
What is the core focus of this habilitation thesis?
The thesis examines the economic and health-related viability of implementing a government-sponsored, quarterly point-of-care HbA1c monitoring program for non-insulin-dependent type 2 diabetes patients in Ukraine.
What are the primary themes discussed in the work?
Key themes include the health burden of type 2 diabetes, the clinical necessity of improved glycaemic control, health economics (BIA and CEA), and the practical implementation of better monitoring protocols in Eastern European healthcare systems.
Does the research define a specific research question?
Yes, the central question is whether Ukraine should transition to a national quarterly point-of-care HbA1c monitoring strategy, and if the associated costs of this strategy are outweighed by the health benefits.
Which scientific methods are utilized?
The author employs a combination of Budget Impact Analysis (BIA) and Cost-Effectiveness Analysis (CEA), supported by a Markov decision model to simulate disease progression and health outcomes over time.
What topics does the main body of the text cover?
The text focuses on the disease pathophysiology, current monitoring guidelines in Ukraine, a review of cost-effectiveness literature, and detailed modeling of clinical outcomes versus budgetary costs for various patient scenarios.
How can this work be categorized via its keywords?
The work is categorized by terms relating to diabetes management, public health economics, healthcare technology assessment, and specifically, Ukrainian medical policy.
How does the transition to point-of-care testing affect Ukrainian healthcare costs?
The analysis indicates that while the switch leads to higher immediate operational costs for testing and primary care physician time, these costs are balanced against the prevention of costly, long-term diabetes-related complications.
What did the sensitivity analysis reveal about the proposed policy?
The sensitivity analysis confirmed that the quarterly POC-based strategy remains a robust and cost-effective option across most modelled parameters, provided a reasonable willingness-to-pay threshold is established.
- Arbeit zitieren
- Artem Boltyenkov (Autor:in), 2021, A Healthcare Economic Policy for Non-Insulin-Dependent Diabetes Mellitus Type 2 Patients Monitoring in Ukraine, München, GRIN Verlag, https://www.grin.com/document/1239366
