COST EFFECTIVENESS OF SCREENING OF ALL NEWLY RECRUITED EMPLOYEES FOR DIABETES AT A TERTIARY CARE HOSPITAL
AbstractBackground: Diabetes Mellitus is a disease which remains asymptomatic for long duration oftime and usually diagnosed either when gets complicated or by routine or opportunistic screening.The practice of universal screening is not recommended, particularly in constraint resources.However, we embarked with a study to assess the yield of recommended screening f or Type 2diabetes in all the newly recruited employees at a tertiary care hospital in Karachi. Methods: Allthe information required for this study was collected from medical records of all newly recruitedemployees of nursing services department of a tertiary care hospital of Karachi, Pakistan, over aperiod of 5 months (August 2004 to December 2004). Out of 360 subjects , 326, whoseinformation was found to be complete, were included for final analysis. Results: Mean age of thestudy subjects was 25.3 ± 4.7 years and their mean casual plasma glucose level was 99.1 ± 16.3mg/dl. 315 (96.6%) study subjects had casual plasma glucose level of 139 mg/dl or less. Only 10(3.1%) study subjects had casual plasma glucose levels between 140 to 199 mg/dl. Just oneemployee, 41 years old, was found to have casual plasma glucose level of 213 mg/dl. Conclusion:In this study, screening of all individuals for diabetes had a very low yield. Recommendation ofuniversal screening for diabetes does not represent a good use of resources and perhaps not costeffective. However, periodic screening of high risk individuals should be warranted.Key words: Diabetes; Screening; Population; Cost-effectiveness
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