Yu-Chien Chung , Yi-Wei Kao , Yen-Chun Huang , Pei-En Chen , Shu-Chen Liao , Chih-Kuang Liu , Mingchih Chen
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Outcome measures included the proportion of patients who developed DR, who received DR treatment, and the associated medical expenses and hospitalizations.</p></div><div><h3>Results</h3><p>The 17-year cohort included 337,046 patients. After PSM, three groups each containing 35,739 patients were assembled and analyzed. Compared to low-frequency screening, high-frequency screening was more effective in detecting patients requiring treatment; however, the net cost for treatment was significantly lower. Standard-frequency screening appears to provide the best balance in terms of DR detection, diagnosis interval, the risk of DR-related hospitalization, and DR treatment costs.</p></div><div><h3>Conclusions</h3><p>In this real-world cohort study covering all levels of the healthcare system, infrequent screening was associated with delayed diagnosis and elevated treatment costs, while a fundus screening interval of 1–2 years proved optimal in terms of detection and medical expenditures.</p></div>","PeriodicalId":8594,"journal":{"name":"Asia-Pacific Journal of Ophthalmology","volume":null,"pages":null},"PeriodicalIF":3.7000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2162098924000720/pdfft?md5=5325c510e97d01d39654289e634f6601&pid=1-s2.0-S2162098924000720-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Cost-effectiveness of diabetic retinopathy screening for newly diagnosed type 2 diabetic patients: A nationwide population-based propensity score-matched cohort study\",\"authors\":\"Yu-Chien Chung , Yi-Wei Kao , Yen-Chun Huang , Pei-En Chen , Shu-Chen Liao , Chih-Kuang Liu , Mingchih Chen\",\"doi\":\"10.1016/j.apjo.2024.100071\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Aims</h3><p>This study investigated the association between the frequency of screening for diabetic retinopathy (DR) versus the development of DR and corresponding medical expenses among patients newly diagnosed with type 2 diabetes mellitus (T2DM).</p></div><div><h3>Methods</h3><p>This longitudinal, population-based study used the Taiwan National Health Insurance Research Database (2004 to 2020) as a data source. 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引用次数: 0
摘要
目的:本研究调查了新诊断为 2 型糖尿病(T2DM)的患者中,糖尿病视网膜病变(DR)筛查频率与 DR 发展及相应医疗费用之间的关联:这项基于人群的纵向研究以台湾国民健康保险研究数据库(2004-2020年)为数据来源。研究采用倾向得分匹配法(PSM)(性别、年龄、合并症和同时用药),根据不同的 DR 筛查频率对 T2DM 患者进行分组。结果衡量指标包括发生 DR 的患者比例、接受 DR 治疗的患者比例以及相关的医疗费用和住院费用:17 年的队列包括 337046 名患者。经过 PSM 筛选后,对各包含 35739 名患者的三个组进行了汇总和分析。与低频筛查相比,高频筛查能更有效地发现需要治疗的患者;但治疗的净成本却明显较低。标准频率筛查似乎在DR检出率、诊断间隔、DR相关住院风险和DR治疗成本方面实现了最佳平衡:在这项涵盖各级医疗系统的真实世界队列研究中,筛查频率过低与诊断延迟和治疗成本增加有关,而眼底筛查间隔 1-2 年则被证明在检出率和医疗支出方面是最佳的。
Cost-effectiveness of diabetic retinopathy screening for newly diagnosed type 2 diabetic patients: A nationwide population-based propensity score-matched cohort study
Aims
This study investigated the association between the frequency of screening for diabetic retinopathy (DR) versus the development of DR and corresponding medical expenses among patients newly diagnosed with type 2 diabetes mellitus (T2DM).
Methods
This longitudinal, population-based study used the Taiwan National Health Insurance Research Database (2004 to 2020) as a data source. Propensity score matching (PSM) (sex, age, comorbidities and concurrent medication use) was employed in the grouping of T2DM patients according to different frequency of DR screening. Outcome measures included the proportion of patients who developed DR, who received DR treatment, and the associated medical expenses and hospitalizations.
Results
The 17-year cohort included 337,046 patients. After PSM, three groups each containing 35,739 patients were assembled and analyzed. Compared to low-frequency screening, high-frequency screening was more effective in detecting patients requiring treatment; however, the net cost for treatment was significantly lower. Standard-frequency screening appears to provide the best balance in terms of DR detection, diagnosis interval, the risk of DR-related hospitalization, and DR treatment costs.
Conclusions
In this real-world cohort study covering all levels of the healthcare system, infrequent screening was associated with delayed diagnosis and elevated treatment costs, while a fundus screening interval of 1–2 years proved optimal in terms of detection and medical expenditures.
期刊介绍:
The Asia-Pacific Journal of Ophthalmology, a bimonthly, peer-reviewed online scientific publication, is an official publication of the Asia-Pacific Academy of Ophthalmology (APAO), a supranational organization which is committed to research, training, learning, publication and knowledge and skill transfers in ophthalmology and visual sciences. The Asia-Pacific Journal of Ophthalmology welcomes review articles on currently hot topics, original, previously unpublished manuscripts describing clinical investigations, clinical observations and clinically relevant laboratory investigations, as well as .perspectives containing personal viewpoints on topics with broad interests. Editorials are published by invitation only. Case reports are generally not considered. The Asia-Pacific Journal of Ophthalmology covers 16 subspecialties and is freely circulated among individual members of the APAO’s member societies, which amounts to a potential readership of over 50,000.