Cost-effectiveness of the adherence with recommendations for clinical monitoring of patients with diabetes

Autor: Giovanni Corrao, Federico Rea, Giuseppe Mancia, Gianluca Perseghin, Luca Merlino, Nello Martini, Simona Carbone, Flavia Carle, Andrea Bucci, Marianxhela Dajko, Silvia Arcà, Donata Bellentani, Velia Bruno, Carla Ceccolini, Angela De Feo, Lucia Lispi, Rosanna Mariniello, Maurizio Masullo, Federica Medici, Paola Pisanti, Modesta Visca, Rinaldo Zanini, Teresa Di Fiandra, Natalia Magliocchetti, Giovanna Romano, Anna Cantarutti, Pietro Pugni, Marina Davoli, Mirko Di Martino, Adele Lallo, Patrizia Vittori, Giuliana Vuillermin, Alfonso Bernardo, Anna Fusciante, Laura Belotti, Rossana De Palma, Enza Di Felice, Roberta Chiandetti, Elena Clagnan, Stefania Del Zotto, Andrea Di Lenarda, Aldo Mariotto, Marisa Prezza, Loris Zanier, Danilo Fusco, Chiara Marinacci, Antonio Lora, Liana Spazzafumo, Simone Pizzi, Maria Simiele, Giuseppe Massaro, Ettore Attolini, Vito Lepore, Vito Petrarolo, Giovanni De Luca, Giovanna Fantaci, Sebastiano Pollina Addario, Salvatore Scondotto, Francesco Bellomo, Mario Braga, Valeria Di Fabrizio, Silvia Forni, Paolo Francesconi, Francesco Profili, Francesco Avossa, Matteo Corradin, Silvia Vigna, Letizia Dondi, Antonella Pedrini, Carlo Piccinni, Mimma Cosentino, Maria G. Marvulli, Aldo Maggioni
Přispěvatelé: Corrao, G, Rea, F, Mancia, G, Perseghin, G, Merlino, L, Martini, N, Carbone, S, Carle, F, Bucci, A, Dajko, M, Arca, S, Bellentani, D, Bruno, V, Ceccolini, C, De Feo, A, Lispi, L, Mariniello, R, Masullo, M, Medici, F, Pisanti, P, Visca, M, Zanini, R, Di Fiandra, T, Magliocchetti, N, Romano, G, Cantarutti, A, Pugni, P, Davoli, M, Di Martino, M, Lallo, A, Vittori, P, Vuillermin, G, Bernardo, A, Fusciante, A, Belotti, L, De Palma, R, Di Felice, E, Chiandetti, R, Clagnan, E, Del Zotto, S, Di Lenarda, A, Mariotto, A, Prezza, M, Zanier, L, Fusco, D, Marinacci, C, Lora, A, Spazzafumo, L, Pizzi, S, Simiele, M, Massaro, G, Attolini, E, Lepore, V, Petrarolo, V, De Luca, G, Fantaci, G, Pollina Addario, S, Scondotto, S, Bellomo, F, Braga, M, Di Fabrizio, V, Forni, S, Francesconi, P, Profili, F, Avossa, F, Corradin, M, Vigna, S, Dondi, L, Pedrini, A, Piccinni, C, Cosentino, M, Marvulli, M, Maggioni, A
Rok vydání: 2021
Předmět:
Diagnostic Screening Programs
Male
medicine.medical_specialty
Time Factors
Databases
Factual
National Health Programs
Cost effectiveness
Endocrinology
Diabetes and Metabolism
Cost-Benefit Analysis
Population
Medicine (miscellaneous)
Audit
Diagnostic Techniques
Ophthalmological
Diabete
Kidney Function Tests
Cost Savings
Predictive Value of Tests
Diabetes mellitus
Health care
medicine
Diabetes Mellitus
Healthcare cost
Humans
education
Aged
Incremental cost-effectiveness ratio
education.field_of_study
Nutrition and Dietetics
medicine.diagnostic_test
business.industry
Periodic examination
Health Care Costs
Middle Aged
medicine.disease
Prognosis
Population-based cohort study
Real-world
Italy
Cost-effectivene
Emergency medicine
Patient Compliance
Female
Cardiology and Cardiovascular Medicine
business
Lipid profile
Complication
Blood Chemical Analysis
Cohort study
Zdroj: Nutrition, metabolism, and cardiovascular diseases : NMCD. 31(11)
ISSN: 1590-3729
Popis: Background and aims To validate a set of indicators for monitoring the quality of care of patients with diabetes in ‘real-life’ practice through its relationship with measurable clinical outcomes and healthcare costs. Methods and results A population-based cohort study was carried out by including the 20,635 patients, residents in the Lombardy Region (Italy), who in the year 2012 were newly taken-in-care for diabetes. Adherence with clinical recommendations (i.e., controls for glycated haemoglobin, lipid profile, urine albumin excretion and serum creatinine) was recorded during the first year after the patient was taken-in-care, and categorized according whether he/she complied with none or almost none (0 or 1), just some (2) or all or almost all (3 or 4) the recommendations, respectively denoted as poor, intermediate and high adherence. Short- and long-term complications of diabetes, and healthcare cost incurred by the National Health Service, were assessed during follow-up. Compared with patients with poor adherence, those with intermediate and high adherence respectively showed (i) a delay in outcome occurrence of 13 days (95% CI, -2 to 27) and 23 days (9 to 38), and (ii) a lower healthcare cost of 54 € and 77 €. In average, a gain of 18 Euros and 15 Euros for each day free from diabetic complication by increasing adherence respectively from poor to intermediate and from poor to high were observed. Conclusion Close control of patients with diabetes through regular clinical examinations must be considered the cornerstone of national guidance, national audits, and quality improvement incentive schemes.
Databáze: OpenAIRE
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