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- Title
Long-term cost-effectiveness of quality of diabetes care; experiences from private and public diabetes centers in Iran.
- Authors
Shahtaheri, Rahill Sadat; Bayazidi, Yahya; Davari, Majid; Kebriaeezadeh, Abbas; Yousefi, Sepideh; Hezaveh, Alireza Mahdavi; Sadeghi, Abolfazl; aL Lami, Ahmed Hayder Mohsin; Abbasian, Hadi
- Abstract
Background: The quality of health care has a significant impact on both patients and the health system in terms of long-term costs and health consequences. This study focuses on determining the long-term cost-effectiveness in quality of diabetes care in two different settings (private/public) using longitudinal patient-level data in Iran. Methods: By extracting patients intermediate biomedical markers in under-treatment type 2 diabetes patients(T2DP) in a longitudinal retrospective study and by applying the localized UKPDS diabetes model, lifetime health outcomes including life expectancy, quality-adjusted Life expectancy (QALE) and direct medical costs of managing disease and related complications from a healthcare system perspective was predicted. Costs and utility decrements had derived on under-treatment T2DP from 7 private and 8 Public diabetes centers. We applied two steps sampling mehods to recruit the needed sample size (cluster and random sampling). To cope with first and second-order uncertainty, we used Monte-Carlo simulation and bootstrapping techniques. Both cost and utility variables were discounted by 3% in the base model. Results: In a 20-year time horizon, according to over 5 years of quality of care data, outcomes-driven in the private sector will be more effective and more costly (5.17 vs. 4.95 QALE and 15,385 vs. 8092). The incremental cost-effectiveness ratio (ICER) was $33,148.02 per QALE gained, which was higher than the national threshold. Conclusion: Although quality of care in private diabetes centers resulted in a slight increase in the life expectancy in T2DM patients, it is associated with unfavorable costs, too. Private-sector in management of T2DM patients, compared with public (governmental) diabetic Centers, is unlikely to be cost-effective in Iran.
- Subjects
IRAN; PEOPLE with diabetes; MEDICAL quality control; TYPE 2 diabetes; COST effectiveness; DIABETES; MONTE Carlo method
- Publication
Health Economics Review, 2022, Vol 12, Issue 1, p1
- ISSN
2191-1991
- Publication type
Article
- DOI
10.1186/s13561-022-00377-9