| Summary: | <p><strong>Aims</strong><br/> In England and Wales, the National Diabetes Audit (NDA) assesses the quality of Type 2 diabetes (T2D) management in primary care using treatment targets for HbA1c ≤ 58mmol/mol, total cholesterol < 5mmol/L, and blood pressure ≤ 140/80mmHg. We quantify the impact of variation across general practitioners’ (GP) practices in achieving these targets on patients’ health outcomes and healthcare costs.</p><br/> <p><strong>Methods</strong><br/> Summary characteristics of T2D patients from the 2015-2016 NDA were used to generate representative populations of T2D patients. The UKPDS Outcomes Model 2 was used to estimate patients’ long-term health outcomes and healthcare costs. The effects of achieving treatment targets on these outcomes were evaluated using regression models.</p><br/> <p><strong>Results</strong><br/> Achieving more of the HbA1c, cholesterol and blood pressure targets led to lower incidences of diabetes-related complications. About 0.5 (95%CI: 0.4-0.6) QALYs and 0.6 (95%CI: 0.4-0.7) LYs were gained by T2D patient over lifetime for each additional target met. The projected healthcare cost savings arising from fewer diabetes-related complications with achieving one, two or three targets compared to none were £859 (95%CI: £553-£1165), £940 (95%CI: £485-£1395), and £1037 (95%CI: £414-£1660) over patient’s lifetime. A typical GP practice in the lowest performing decile (average 371 T2D patients per practice, with 27% achieving all targets) is projected to gain 201 (95%CI: 123-279) QALYs and 231 (95%CI: 133-329) LYs, if all its T2D patients achieved all three targets.</p><br/> <p><strong>Conclusions</strong><br/> Substantial gains in health outcomes and reductions in healthcare cost could be achieved with further improvements in attainment of HbA1c, cholesterol and blood pressure targets for T2D patients.</p>
|
|---|