Annals of Occupational and Environmental Medicine

Original Article

A Cost-Effectiveness Analysis of Mass Screening for Diabetes Mellitus: Kyung Eun Lee, Byung Yeol Chun, Sin Kam, Jae Yong Park; Korean Journal of Occupational and Environmental Medicine 1995;7(2):269-281. Published online October 31, 1995; DOI: https://doi.org/10.35371/kjoem.1995.7.2.269

Abstract PDF: To evaluate the efficiency of the diabetes mellitus screening program, the records of screening examinations for general workers and official workers at a general hospital in Taegu city were analysed. Six alternatives of the diabetes mellitus screening program were compared in terms of cost-effectiveness. The screening program I which was already used in the examination for general workers, screening program II for official workers, alternative program (A) which was the same method as screening program I without urine sugar test for the second examination in a hospital, a1ternative program (B) with the test for fasting blood sugar (FBS) in a worksite, alternative program (C) with the test for postprandial blood sugar (PPBS) in a worksite, alternative program (D) with the first test for FBS and the second test for PPBS of negatives for FBS test in a worksite, alternative program (E) with the first test for PPBS and the second test for FBS of negatives for PPBS test, and alternative program (F) with the test for urine sugar in a worksite. To compare the cost-effectiveness between alternatives, the cost (Won) per positive detected for diabetes mellitus (cost-effectiveness ratio) was calculated. The cost per positive detected was 37,767 Won for screening program I, 50,441 for screening program II, 37,433 for alternative program (A) , 27,645 for alternative program (B), and if it was assumed that the positive rate for negatives of FBS would be 2.0 %, 28,541 for alternative program (C) , 35,458 for alternative program (D) , 38,488 for alternative program (E) . However, that for alternative program (F) was varied with the positive predictive value (PPV) of urine sugar test for diabetes. The cost per positive detected was lowest(18,689 Won) when PPV was 93 %, whereas, highest (88,106) when PPV was 20 %. The critical value of PPV was 64 %. The alternative program (F) was most efficient when PPV was 64% or more. Considering the prevalence for diabetes mellitus, PPV for urine suger test, and feasibility of screening examination, alternative program (B) will be proved as the most efficient screening program. In conclusion, either program (B) or program (F) will be the most efficient method for screening a large population depending on the positive predictive value of fasting urine suger test.

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