Estimation of mortality savings due to a national program for diabetes care

Dreiher, Jacob; Ginsberg, Gary; Rabinowitz, Gad; Raskin-Segal, Anat; Weitzman, Ron; Porath, Avi

doi:10.1016/j.ejim.2008.09.003

« Previous Next »European Journal of Internal Medicine
Volume 20, Issue 3 , Pages 307-312, May 2009

Estimation of mortality savings due to a national program for diabetes care

Jacob Dreiher
- Clalit Health Services, Israel
- Division of Health in the Community, Ben Gurion University of the Negev, Beer Sheva, Israel
- Corresponding author. Division of Health in the Community, Faculty of Health Sciences, Ben Gurion University of the Negev, PO Box 653, Beer Sheva, 84150 Israel. Tel.: +972 3 694 6577/6; fax: +972 3 760 8737.
Gary Ginsberg
- Department of Medical Technology Assessment, Ministry of Health, Jerusalem, Israel
Gad Rabinowitz
- Department of Industrial Engineering and Management, Ben Gurion University of the Negev, Beer Sheva, Israel
Anat Raskin-Segal
- Department of Industrial Engineering and Management, Ben Gurion University of the Negev, Beer Sheva, Israel
Ron Weitzman
- Department of Industrial Engineering and Management, Ben Gurion University of the Negev, Beer Sheva, Israel
Avi Porath
- Clalit Health Services, Israel
- Department of Epidemiology, Ben Gurion University of the Negev, Beer Sheva, Israel
- Department of Internal Medicine, Ben Gurion University of the Negev, Beer Sheva, Israel

Received 8 January 2008; received in revised form 28 August 2008; accepted 3 September 2008. published online 22 October 2008.

Abstract

Background

Diabetes-related complications can be reduced by better control of glycemia, lipid abnormalities and blood pressure. In recent years, efforts at improving diabetes care in Israel have been made. This study aims to estimate mortality savings related to a national program for diabetes care in Israel.

Methods

Total population data for Israel was projected to 2020. Current diabetes prevalence and disease management data were obtained from a national program of diabetes care. Projections of the program's effect were based on two models: improvement in glycemic control, reflected in Hb A1c levels, and improvement in overall diabetes care, reflected in the percentage with LDL<100 mg/dl, a proxy for multi-factorial control. Potential years of life lost (PYLL) and quality-adjusted life years (QALYs) saved were calculated.

Results

A drop in average Hb A1c values from 8.13% at baseline to 7.36% in 2020 is expected, and as a result 4216 deaths from diabetes will be prevented over the period 2001–2020, saving around 47,773 life years or 34,342 QALYs. Overall diabetes care, reflected in improving the control rate of LDL levels to <100 mg/dl from 36% in 2000 to 58% in 2020, is estimated to prevent around 4803 deaths from diabetes over the period 2001–2020., so the program will save around 47,127 PYLL or 32,862 QALYs.