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Int. J. Environ. Res. Public Health 2014, 11(5), 4939-4952; doi:10.3390/ijerph110504939

Health Utilities of Type 2 Diabetes-Related Complications: A Cross-Sectional Study in Sweden

1,2,3,* , 1,3,4
1 Health Economics Unit, Department of Clinical Sciences, Lund University, Lund 22381, Sweden 2 School of Public Health, Department of Health Management and Economics, Tehran University of Medical Sciences, Tehran 141556447, Iran 3 Institute of Economic Research, Health Economics & Management, Lund University, Lund 22007, Sweden 4 Department of Economics, Lund University, Lund 22363, Sweden 5 Sahlgrenska University Hospital, Department of Medicine, University of Gothenburg, Gothenburg 41345, Sweden
* Author to whom correspondence should be addressed.
Received: 24 February 2014 / Revised: 1 April 2014 / Accepted: 4 May 2014 / Published: 7 May 2014
(This article belongs to the Special Issue Diabetes Prevention: Challenges and Opportunities)
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This study estimates health utilities (HU) in Sweden for a range of type 2 diabetes-related complications using EQ-5D and two alternative tariffs (UK and Swedish) from 1757 patients with type 2 diabetes from the Swedish National Diabetes Register (NDR). Ordinary least squares were used for statistical analysis. Lower HU was found for female gender, younger age at diagnosis, higher BMI, and history of complications. Microvascular and macrovascular complications had the most negative effect on HU among women and men, respectively. The greatest decline in HU was associated with kidney disorders (−0.114) using the UK tariff and stroke (−0.059) using the Swedish tariff. Multiple stroke and non-acute ischaemic heart disease had higher negative effect than a single event. With the UK tariff, each year elapsed since the last microvascular/macrovascular complication was associated with 0.013 and 0.007 units higher HU, respectively. We found important heterogeneities in effects of complications on HU in terms of gender, multiple event, and time. The Swedish tariff gave smaller estimates and so may result in less cost-effective interventions than the UK tariff. These results suggest that incorporating subgroup-specific HU in cost-utility analyses might provide more insight for informed decision-making.
Keywords: EQ-5D; health utility; Sweden; type 2 diabetes EQ-5D; health utility; Sweden; type 2 diabetes
This is an open access article distributed under the Creative Commons Attribution License (CC BY 3.0).

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Kiadaliri, A.A.; Gerdtham, U.-G.; Eliasson, B.; Gudbjörnsdottir, S.; Svensson, A.-M.; Carlsson, K.S. Health Utilities of Type 2 Diabetes-Related Complications: A Cross-Sectional Study in Sweden. Int. J. Environ. Res. Public Health 2014, 11, 4939-4952.

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