Cost and effectiveness of screening methods for abnormal fasting plasma glucose among Thai adults participating in the annual health check-up at king chulalongkorn memorial hospital

Abstract

Background: In Thailand, type 2 diabetes screening was implementing at national level by the Ministry of Public Health (MOPH) recommendation but screening methods have not been fully evaluated. Objective: To compare the performance, cost, and cost-effectiveness of four screening methods in identifying individuals with abnormal fasting plasma glucose among Thai adults participating in the annual health check-up at King Chulalongkorn Memorial Hospital. Material and Method: Individuals aged 35 to 60 years old with no known abnormal fasting plasma glucose (2,977 persons) were recruited. All subjects completed a set of screening questionnaires and were tested for venous fasting plasma glucose (FPG). One-time screening performance and costs were analyzed. Results: Sensitivities of all screening methods ranged from 71 to 92%, while specificities were between 31 and 57%. The total costs of screening per one newly detected case were 59.12 to 69.62 US dollars (2,022 to 2,381 bahts). Compared to the universal FPG test, all screening methods using questionnaires were relatively more cost-effective. Their relative costeffectiveness was, however, not obviously different. Conclusion: Other factors should also be considered in selecting type 2 diabetes screening method for specific population in Thailand.