Population-based screening was found to be associated with a reduction in admissions, physician visits, and prescribed medication for individuals diagnosed with type 2 diabetes.
Screening for diabetes and cardiovascular disease is associated with reduced mortality and risk; however, the effects of screening on health care costs at the population level has been largely unknown.
In a recently-published population-based study, early detection and treatment of type 2 diabetes was found to reduce health care costs for the general population in Denmark.
For the study, the researchers evaluated a cardiovascular and diabetes screening program introduced in 5 out of 16 counties in Denmark. Between 2001 and 2006, more than 150,000 individuals registered with the 181 general practices participating in the trial were sent a diabetes risk score questionnaire. If their score indicated moderate to high risk, participants were invited to receive a diabetes test and a cardiovascular risk assessment with their family physician.
Of the eligible individuals in the screening group who were sent a diabetes questionnaire, 18% visited their physician for a diabetes test and a cardiovascular risk assessment. A total of 1533 individuals were diagnosed with diabetes, of whom 1406 were subsequently included in the diabetes register.
Participants were followed for approximately 6 years following diagnosis until December 31, 2012, when national registers were searched for health care usage and cost.
Overall, the researchers found that individuals with clinically-diagnosed diabetes were identified on average 2.2 years later than individuals whose diabetes was detected in the screening process. The researchers also found that health care costs were significantly lower in the screening group compared with the no-screening control group.
Primary care costs were approximately 5% higher in the no-screening group than the screening group during follow-up. Medication costs were already higher in the no-screening group before diagnosis, but the difference between groups increased further after diabetes diagnosis. There were no clear trends associated with the point of diabetes diagnosis for inpatient and outpatient visits.
According to the study, the relatively modest cost of screening per participant in the trial who was diagnosed with diabetes was offset within 2 years by health care savings. Modeling studies indicate that screening for type 2 diabetes at the population level would be cost-effective over 30 to 50 years, the researchers concluded.
Sortsø C, Komkova A, Sandbæk A, et al. Effect of screening for type 2 diabetes on healthcare costs: a register-based study among 139,075 individuals diagnosed with diabetes in Denmark between 2001 and 2009. Diabetologia. https://www.springermedizin.de/effect-of-screening-for-type-2-diabetes-on-healthcare-costs-a-re/15542004?fulltextView=true.