One of the main activities of the International Diabetes Federation's health economics work is conducting studies to assess the economic and social impact of diabetes. IDF has to date conducted Diabetes Social and Economic Impact Studies (DIS) in 5 African countries - Cameroon, Kenya, Mali, Tanzania, and South Africa - and in 12 study sites in China. Further studies are underway in 3 regions in Kazakhstan.
The countries chosen were selected for opportunity and value and all investigators and other individuals involved volunteered their time. The studies received sponsorship from the following companies: GlaxoSmithKline, Lilly Diabetes, Merck Diabetes, Novo Nordisk and Takeda Pharmaceuticals North America.
The primary purpose of the DIS is to provide high quality data the host countries. This information can then be used to organize and manage medical care for their citizens with diabetes by implementing interventions that aim at solving the problems highlighted by the DIS.
The second objective is to provide country specific information on the excess costs of diabetes to support estimates of the medical expenditures for diabetes treatment and prevention published in the IDF Diabetes Atlas. The IDF estimates are created using a special formula which requires information on country estimates of diabetes prevalence by age and sex, population size by age and sex, total healthcare expenditures by age and sex, and the ratio (R) of medical expenditures per person with diabetes to medical expenditures per person without diabetes, matched for age and sex. 'R' is the key parameter in the conversion of per capita health spending in the country into estimates of spending caused by diabetes. The DIS provide data for establishing country specific ratios. The preliminary results from the Social and Economic Impact of Diabetes in China were recently used to estimate the total health care expenditure resulting from diabetes in China in 2008 by establishing the ratio calculated from health care utilisation data reported within the study.
The third aim is to document the global impact of diabetes to support advocacy and investment in diabetes and other NCD care and prevention. As part of this, IDF supports scientific publications by combining research data from all participating countries. A common study design and data repository allows comparisons across countries and regions.
Stakeholder meetings are organised to communicate and share the results of the DIS. The purpose of these meetings is to discuss and work with relevant national Ministries and other key stakeholders to develop action plans to correct the problems that have been documented by the studies.
The DIS are based on interviews with a number of randomly selected people with diabetes and a corresponding number of people without the condition. The face-to-face interviews cover self-reported health, use of medical services, payments for medical services, the impact of ill health on ability to work and on family members, other health problems, access to medical care, self-care, and tests and treatments received.
The main research questions and areas of analysis include:
- Association between diabetes and other health problems (like tuberculosis, HIV, cardiovascular disease, microvascular complications and depression).
- The impact of diabetes on people with diabetes and their families (out of pocket expenditures, loss of work, lost opportunities for children and other family members, quality of life).
- Impact of diabetes on the health care system.
- Total direct and indirect costs of diabetes to the society.
- Quality of care and access to care (treatments prescribed and used, risk factor monitoring, education, extent of inability to obtain care and the reasons why).
- Impact of diabetes on national economic growth and development.
Study materials for performing the DIS include:
- Study protocol
- Study questionnaire
- Study consent
- Case-control tracking instructions
- Interview guidance
- EpiData entry system
Below you find a downloadable zip file which contains the study materials used for our DIS in Africa. You are free to adapt it to your needs. The package is available in English and in French. It includes the normal version of the questionnaire and the data entry system as well as a more condensed version.