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
Nipa Srichang MSc*, Wiroj Jiamjarasrangsi MD, PhD**, Wichai Aekplakorn MD, PhD***, Siripen Supakankunti PhD****
Affiliation : * College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand ** Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand *** Community Medicine Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand **** Centre for Health Economics, Faculty of Economics, Chulalongkorn University, Bangkok, Thailand
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 cost-
effectiveness was, however, not obviously different.
Conclusion : Other factors should also be considered in selecting type 2 diabetes screening method for specific population in
Thailand.
Keywords : Type 2 diabetes, Screening methods, Fasting plasma glucose, Cost
