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Health-related quality of life and health utilities in insulin-treated type 2 diabetes: the impact of related comorbidities/complications

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  • John Yfantopoulos

    (National and Kapodistrian University of Athens)

  • Athanasios Chantzaras

    (National and Kapodistrian University of Athens)

Abstract

Objective To evaluate the impact of multiple comorbidities/complications on health-related quality of life (HRQoL) and health utilities in insulin-treated type 2 diabetes (T2DM). Methods In a non-interventional, epidemiological study, data were collected from medical records and via interviews for 938 subjects from various geographical areas of Greece. HRQoL and health utilities were explored with the EQ-5D-5L. Univariate associations were evaluated with the Mann–Whitney and Kruskal–Wallis tests for continuous and Chi-squared tests for nominal variables, and binary logistic regressions were employed to obtain marginal effects. Employing a split sample approach, various specifications of ordinary least squares regression models were evaluated in terms of goodness of fit, model specification, shrinkage and predictive and discriminative performance, to select the best model for mapping health utilities using the whole dataset. Results Overall, the most important factors of impaired HRQoL and health utilities were higher age, female gender, obesity, poor glycemic control and increased duration of insulin treatment. History and increasing concurrence of all complications assessed were associated with exacerbated HRQoL problems, decreased health utilities and diminished health state, although it was not always statistically significant. The highest disutilities were associated with stroke (− 0.082), diabetic retinopathy (− 0.066), diabetic neuropathy (− 0.051) and severe hypoglycemia (− 0.050). Conclusions The deleterious impact of comorbidities on insulin-dependent T2DM subjects’ HRQoL has been confirmed and clinicians should adapt the priorities of disease management accordingly. The derived health utility estimates may be valuable for conducting economic evaluations of interventions in the area of T2DM when data are not available.

Suggested Citation

  • John Yfantopoulos & Athanasios Chantzaras, 2020. "Health-related quality of life and health utilities in insulin-treated type 2 diabetes: the impact of related comorbidities/complications," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(5), pages 729-743, July.
  • Handle: RePEc:spr:eujhec:v:21:y:2020:i:5:d:10.1007_s10198-020-01167-y
    DOI: 10.1007/s10198-020-01167-y
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    References listed on IDEAS

    as
    1. Nick Kontodimopoulos & Evelina Pappa & Zinovia Chadjiapostolou & Eleni Arvanitaki & Angelos Papadopoulos & Dimitris Niakas, 2012. "Comparing the sensitivity of EQ-5D, SF-6D and 15D utilities to the specific effect of diabetic complications," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(1), pages 111-120, February.
    2. Marcel Bilger & Willard G. Manning, 2015. "Measuring Overfitting In Nonlinear Models: A New Method And An Application To Health Expenditures," Health Economics, John Wiley & Sons, Ltd., vol. 24(1), pages 75-85, January.
    3. Maria Alva & Alastair Gray & Borislava Mihaylova & Philip Clarke, 2014. "The Effect Of Diabetes Complications On Health‐Related Quality Of Life: The Importance Of Longitudinal Data To Address Patient Heterogeneity," Health Economics, John Wiley & Sons, Ltd., vol. 23(4), pages 487-500, April.
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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Chris Sampson’s journal round-up for 27th July 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-07-27 11:00:01

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    More about this item

    Keywords

    Health-related quality of life; Health utilities; Type 2 diabetes; Mapping; EQ-5D; Greece;
    All these keywords.

    JEL classification:

    • I10 - Health, Education, and Welfare - - Health - - - General
    • C1 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General

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