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KMID : 0904520090260010041
Health and Medical Sociology
2009 Volume.26 No. 1 p.41 ~ p.65
Cost-Effectiveness Analysis of Type 2 DM Screening Program of National Health Insurance
Lee Ae-Kyung

Lee Sang-Yi
Jeong Hyeon-Jin
Han Jun-Tae
Kwon Hye-Young
Park Hyeung-Keun
Kim Su-Young
Abstract
While health screening service of the National Health Insurance Corporation (NHIC) is the largest health screening program in South Korea, its costeffectiveness has not been examined. The present study, therefore, conducted cost-effective analysis of Type 2 Diabetes Mellitus(DM) screening that is a part of NHIC health screening program. Of simulated cohort selected among all health screening participants in 1996, a Markov process model that reflects natural course of Type 2 DM was used to predict the occurrence of DM and its complications until death or 100 years of age. The distribution of DM and its Complications that was initial input data for Markov process model was extracted from individual 10-year cohort data from NHIC database.
The results show that the Type 2 DM screening group compared to non-DM screening group increased 0.76 life year gained (LYG) and 0.23 quality-adjusted life years (QALY) per person and reduced 370,000 won per person from the insurer¡¯s perspective and 7,200,000 won per person from the societal perspective for asymptomatic diabetic patient.
This total medical cost reduction is attributable to the reduced direct and indirect medical treatment costs for less complications of DM by early detection. The incremental cost effectiveness ratio was -3,132,215won/QALY and -943,316won/LYG. The results of the present study proved that NHIC DM Screening is effective in extending the quality of life as well as reducing medical cost.
KEYWORD
Cost-Effective Analysis, Type 2 Diabetes Mellitus, Health Screening, Markov Process Model
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