Cost-effectiveness analysis of screening strategies for gestational diabetes mellitus
Journal
Taiwan Journal of Public Health
Journal Volume
38
Journal Issue
4
Pages
387-399
Date Issued
2019
Author(s)
Chou Y.-Y.
Abstract
Objectives: Gestational diabetes mellitus (GDM) is associated with type 2 diabetes mellitus and adverse outcomes for both mothers and infants. Screening is a valuable method for identifying women at risk for GDM, and universal screening along with targeted screening is a key strategy for such identification. However, consensus is lacking regarding which GDM screening strategy is appropriate for pregnant women. Hence, the objective of this study was to compare the cost-effectiveness of GDM screening strategies from the third payer perspective. Methods: A decision tree model was used to assess the costs and quality-adjusted life years (QALYs) for three GDM screening strategies: universal screening, targeted screening, and no screening. The Taiwan National Health Insurance Research Database and a literature review were used to estimate the model parameters. Sensitivity analysis was performed to evaluate the robustness of assessment. Results: Compared with the no screening strategy, universal screening and targeted screening were cost-effective. Universal screening was a cost-effective approach for decreasing the risks of GDM complications compared with targeted screening or no screening. Relative to targeted screening, universal screening generated an incremental cost-effectiveness ratio of $928/QALY gained. Sensitivity analysis provided similar results. Conclusions: Universal screening is a cost-effective approach for improving maternal and neonatal outcomes.
SDGs
Publisher
Chinese Public Health Association of Taiwan
Type
journal article