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Long-term cost-effectiveness of quality of diabetes care; experiences from private and public diabetes centers in Iran

Author

Listed:
  • Rahill Sadat Shahtaheri

    (Tehran University of Medical Sciences)

  • Yahya Bayazidi

    (Tehran University of Medical Sciences)

  • Majid Davari

    (Tehran University of Medical Sciences)

  • Abbas Kebriaeezadeh

    (Tehran University of Medical Sciences)

  • Sepideh Yousefi

    (Islamic adad university)

  • Alireza Mahdavi Hezaveh

    (Tehran University of Medical Sciences)

  • Abolfazl Sadeghi

    (Faculty of Pharmacy, Tehran University of Medical Sciences)

  • Ahmed Hayder Mohsin Lami

    (Faculty of Pharmacy, Tehran University of Medical Sciences)

  • Hadi Abbasian

    (Tehran University of Medical Sciences)

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.

Suggested Citation

  • Rahill Sadat Shahtaheri & Yahya Bayazidi & Majid Davari & Abbas Kebriaeezadeh & Sepideh Yousefi & Alireza Mahdavi Hezaveh & Abolfazl Sadeghi & Ahmed Hayder Mohsin Lami & Hadi Abbasian, 2022. "Long-term cost-effectiveness of quality of diabetes care; experiences from private and public diabetes centers in Iran," Health Economics Review, Springer, vol. 12(1), pages 1-7, December.
    • Handle: RePEc:spr:hecrev:v:12:y:2022:i:1:d:10.1186_s13561-022-00377-9
    DOI: 10.1186/s13561-022-00377-9
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    References listed on IDEAS

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    1. Mehdi Javanbakht & Hamid R Baradaran & Atefeh Mashayekhi & Ali Akbar Haghdoost & Mohammad E Khamseh & Erfan Kharazmi & Aboozar Sadeghi, 2011. "Cost-of-Illness Analysis of Type 2 Diabetes Mellitus in Iran," PLOS ONE, Public Library of Science, vol. 6(10), pages 1-7, October.
    2. Mehdi Javanbakht & Atefeh Mashayekhi & Hamid R Baradaran & AliAkbar Haghdoost & Ashkan Afshin, 2015. "Projection of Diabetes Population Size and Associated Economic Burden through 2030 in Iran: Evidence from Micro-Simulation Markov Model and Bayesian Meta-Analysis," PLOS ONE, Public Library of Science, vol. 10(7), pages 1-17, July.
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