Cost analysis of the diagnostic strategies used for diabetes mellitus with decision tree

Abstract

INTRODUCTION: As the prevalence and incidence of diabetes mellitus (DM) continue to rise, the costs of the diagnostic strategies used to detect it have gained importance. The aim of this study was to analyze the cost of DM diagnostic strategies in a hospital setting. METHODS: This cross-sectional study included people over 18 years old with no previous DM diagnosis that presented to the internal medicine outpatient clinic for any reason and underwent serum glucose testing between December 1, 2012 and February 28, 2013. Decision tree analysis was used to calculate weighted costs of the various diagnostic methods. RESULTS: The study included 520 people. The prevalence of DM and pre-DM was 16.3% and 15.0%, respectively. During the study period, the total cost of all tests used was 2164.40 USD, the average cost per person was 4.14 USD, and the average cost per diagnosis was 25.46 USD. The most cost-effective strategy for the diagnosis of DM was FPG and HbA1c tests requested together, while strategies using FPG testing were most cost-effective for the diagnosis of non-DM. DISCUSSION AND CONCLUSION: The diagnostic strategies recommended in national and international guidelines are considerably less costly than many of the strategies used in our hospital. Costs could be lowered by ensuring physicians are aware of and implementing more cost-effective diagnostic strategies.

Keywords

• cost
• cost-effectiveness
• decision tree
• diabetes mellitus
• diagnosis