Understanding Epidemiology of Non-Infectious Diseases and Diabetes Management
Explore the global impact of non-infectious diseases like diabetes, focusing on Type II Diabetes Mellitus. Learn about risk factors, treatment options, and complications associated with diabetes. Discover insights on diabetes prevalence in Cambodia and different models of diabetes management.
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Presentation Transcript
International Health Care Management II Part 1.1-2 Steffen Fle a Institute of Health Care Management University of Greifswald 1
Epidemiology of Non-Infectious Diseases 1. Demand for Health Services 1. Epidemiology of Non-Infectious Diseases 1. Overview 2. Example: Diabetes Mellitus Type II 3. Example: Cervix Uteri Carcinoma 4. Example: Cataract 2. Risk Factors 3. Filter Between Need and Demand 2
1.1.2 Example: Diabetes Mellitus Type II World Diabetes Federation 2019: 463 million diabetics worldwide 4.2 million death cases p.a. 760 billion US$ health expenditure 90 % T2DM 80 % of diabetics live in middle or low income countries 2045 700 million cases 3
T2DM Type-2-Diabetes Chronic Degenerative Disease Insulin resistance Inadequate insulin secretion of -cells, spectrum reaches from predominant insulin resistance accompanied by a relative lack of insulin to a predominant defect of insulin secretion accompanied by insulin resistance Treatment Diet Oral therapy Insulin replacement therapy 4
Complications Micro Vascular Complications Retinopathy (retinal diseases) Nephropathy (kidney disease, dialysis) Macro Vascular Complications Heart Attack Stroke Neuropathy (neurological diseases) Diabetic Foot Ulcers (circulatory disorders of extremities) 6
Diabetes in Cambodia WHO STEPS (2010): Population 25-64 years: 2.9 % countrywide 5.6% urban 2.4% rural exposure to NCD risk factors: 80% had at least one risk factor Source: WHO 2011 Cambodia epidemiologic survey Siem Riep province: 4.8 % Kampong Cham province: 11.4 % Source: WHO 2011 World Development Indicators 2021: 7,3 % countrywide https://ourworldindata.org/grapher/diabetes-prevalence?tab=table 7
Model Undiagnosed, no compli- cations Healthy OAD, no complications Insulin Diet Insulin, complication 8
Model Undiagnosed, no compli- cations Undiagnosed, complication Healthy OAD, no complications Insulin Diet Insulin, complication OAD, complication 9
Model Undiagnosed, no compli- cations Undiagnosed, complication Healthy OAD, no complications Insulin Diet Insulin, complication OAD, complication 10
Model Undiagnosed, no compli- cations Undiagnosed, complication Healthy 1 2 1 OAD, no complications Insulin Diet 1 1 2 2 Insulin, complication OAD, complication non-T2DM death T2DM death 11
Diagnosed and Undiagnosed Cases 300000 250000 200000 Cases 150000 100000 50000 0 2008 2013 2018 2023 2028 Time [Years] diagnosed undiagnosed 12
Diagnosed Cases With and Without Complications 120000 100000 80000 Cases 60000 40000 20000 0 2008 2013 2018 2023 2028 Time [Years] complication no complication 13
Therapy of Diagnosed Cases 120000 100000 80000 Cases 60000 40000 20000 0 2008 2013 2018 2023 2028 Time [Years] diet OAD insulin 14
Budget Impact 4500000 70 4000000 Cumulative Costs [million USD] 60 3500000 50 Cost p.a. [USD] 3000000 40 2500000 2000000 30 1500000 20 1000000 10 500000 0 0 2008 2013 2018 2023 2028 Time [Years] costs p.a. cumulative costs 15
Impact of OAD Coverage (current = 12.5 %) 300000 Incremental Cost per Life Saved: 800 US$ (r=5%) 295000 290000 Death Cases T2DM 285000 280000 275000 270000 265000 260000 255000 250000 Current 0% 25% 50% 75% 100% 16
Impact of Insulin Coverage (basic = 12.5 %) 292000 Incremental Cost per Life Saved: 3392 US$ (r=5%) 290000 Death Cases T2DM 288000 286000 284000 282000 280000 Current 0% 25% 50% 75% 100% 17
Epidemiology of Non-Infectious Diseases 1. Demand for Health Services 1. Epidemiology of Non-Infectious Diseases 1. Overview 2. Example: Diabetes Mellitus Type II 3. Example: Cervix Uteri Carcinoma 4. Example: Cataract 2. Risk Factors 3. Filter Between Need and Demand 18
