| Titre : | The cost-effectiveness of screening for type 2 diabetes. (1998) |
| Auteurs : | Cdc Diabetes Cost-Effectiveness Study Group. INC |
| Type de document : | Article |
| Dans : | JAMA - Journal of the american medical association (n° 20, 1998) |
| Pagination : | 1757-1763 |
| Langues: | Anglais |
| Mots-clés : | Diabète non insulinodépendant ; Dépistage ; Examen clinique ; Diagnostic ; Analyse coût efficacité ; Homme ; Etats Unis ; Amérique ; Glande endocrine [pathologie] ; Economie santé ; Amérique du Nord |
| Résumé : | [BDSP. Notice produite par INIST NmR0xg1Y. Diffusion soumise à autorisation]. Context. - Type 2 diabetes mellitus is a common and serious disease in the United States, but one third of those affected are unaware they have it. Objective. - To estimate the cost-effectiveness of early detection and treatment of type 2 diabetes. Design. - A Monte Carlo computer simulation model was developed to estimate the lifetime costs and benefits of 1-time opportunistic screening (ie, performed during routine contact with the medical care system) for type 2 diabetes and to compare them with current clinical practice. Cost-effectiveness was estimated for all persons aged 25 years or older, for age-specific subgroups, and for African Americans. Data were obtained from clinical trials, epidemiologic studies, and population surveys, and a single-payer perspective was assumed. Costs and benefits are discounted at 3% and costs are expressed in 1995 US dollars. Setting. - Single-payer health care system. Participants. - Hypothetical cohort of 10000 persons with newly diagnosed diabetes from the general US population. Main Outcome Measures. - Cost per additional life-year gained and cost per quality-adjusted life-year (QALY) gained. Results. - The incremental cost of opportunistic screening among all persons aged 25 years or older is estimated at $236 449 per life-year gained and $56 649 per QALY gained. Screening is more cost-effective among younger people and among African Americans. (...) |
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