Doktorarbeit / Dissertation, 2021
151 Seiten, Note: N/A
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
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.
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.
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.
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.
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.
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.
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.
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.
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.
The work is categorized by terms relating to diabetes management, public health economics, healthcare technology assessment, and specifically, Ukrainian medical policy.
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.
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.
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