Effect of lifestyle intervention holistic approach on blood glucose levels, health-related quality of life and medical treatment cost in type 2 diabetes mellitus patients

Type 2 Diabetes Mellitus (T2DM) is a costly, lifestyle-related disorder, its management is very critical and challenging hence lifestyle intervention may a cornerstone in the reversal and management of T2DM. This study designed to assess the impact of lifestyle intervention holistic (LIH) Model on blood glucose levels (BGL), Health-Related Quality of Life (HRQOL), and medical treatment cost in T2DM patients. This prospective, quasi-experimental study was conducted among 224 T2DM patients in Delhi Diabetes Research Center (DDRC), New Delhi. The study participants were allocated into two groups-Lifestyle Intervention Counseling (LIC) group received lifestyle-based counseling through the LIH model while the Usual-care group received only standard treatment. Study outcomes were assessed at baseline, 3rd, 6th, and 12th month and data were analyzed through SPSS. Study results revealed that LIC participants had decreased in fasting blood glucose 0.26 mg dL-1 (-4.37 to 4.89), blood glucose postprandial -70.16 mg dL-1 (-85.15 to - 55.16), HbA1C -2.82% (-5.26 to - 0.37), medicine cost (p < 0.004), hospitalization cost (p < 0.011), and cost of surgery (p < 0.0005). A significant improvement also observed in HRQOL and adherence towards a holistic model in LIC group. The study concludes that lifestyle-based counseling and its adherence was cost-effective and significantly improves BGL, HRQoL, and medical treatment in T2DM patients.

The Effects of Copayments on Healthcare Utilization in Korea’s Medical Aid Program

This study empirically tests the effects of the introduction of copayments on healthcare utilization in the Korea’s medical aid program (MAP). Due to a growing concern about overutilization of public healthcare and government’s financial burden, the Korean government reformed the MAP in 2007 and introduced copayments for outpatient care of Type 1 enrollees who had borne no medical treatment cost until the reform. Exploiting the natural experiment of 2007 reform, we perform a difference-in-differences (DID) analysis with propensity score matching and conclude that the introduction of copayments reduces healthcare utilization in the short-run through heterogeneous effect on the outpatient services consumption distribution, but this effect rapidly disappears over time.

Effect of Lifestyle Intervention on Medical Treatment Cost and Health-Related Quality of Life in Type 2 Diabetes Mellitus Patients

Diabetes is a costly, lifestyle disorder which increases the burden of disease and deteriorates the Health-Related Quality of Life (HRQOL) of diabetes patients and this study was conducted to assess the effect of lifestyle intervention on medical treatment cost and HRQOL in type 2 diabetes mellitus (T2DM) patients. This quasi-experimental prospective study was conducted in Delhi Diabetes Research Center, New Delhi and included 224 T2DM patients. Patients were divided into LMC and usual care group on the basis of receiving or not receiving lifestyle modification counseling. The follow-up of both groups was done at 6th and 12th months. Collected data were analyzed through IBM, SPSS software v 21 for mean, median (min-max), SD, t-test and Wilcoxon scores (rank sums) test. The results of this study showed a statistically significant reduction in diabetes medication costs, hospitalization and surgery costs in the LMC group as compared to the usual care group. The significant improvement was also observed in HRQOL domains which includes - physical functioning (62.40±6.738 to 83.67 ± 5.4920), physical health (35.30±22.069 to 64.50±13.62), emotional problem (37.90±28.93 to71.46±16.75), energy (54.31±11.858 to 80.75 ± 15.52), emotional well-being (63.06± 9.828 to 85.79±6.36), social functioning (38.848±20.805 to 65.54±8.39) and general health (54.51±11.679 to 82.398± 11.7) at 12th month follow up in LMC group. The ADS score also showed significant improvement in overall HRQOL of LMC group. This study concludes that lifestyle intervention may improve HRQOL and reduce medical treatment cost of T2DM patients.

Coping ways of the medical cost in Ischemic Heart Disease patients of Bangladesh

Background : Ischemic Heart Disease (IHD) requires long term treatment which poses huge financial burden.It is very difficult for the patients of developing countries to maintain the treatment costs of IHD.Objectives : To estimate the medical treatment cost and to find out the coping ways of that in Ischemic Heart Disease patients.Methods: A descriptive type of cross sectional study was done during January 2014 to December 2014 at medical out-patient department of National Institute of Cardiovascular Disease (NICVD), Dhaka. Data were collected by using a pre-tested, semi-structured Questionnaire. Medical cost was calculated by drug cost, consultation cost, laboratory investigation cost, surgical cost, hospital cost and food cost. Data analysis was performed by using SPSS software version 20.Results : Out of 201 patients, majority (64.7%) were in the age group of 40-59 years. Most (92.54%)of them were male. Majority (56.2%) of the respondents had monthly family income of Tk. 10001-20000. Among all patients 43.8%spent total medical cost was with a range from Tk.50001-180000. 85.71%, 81.8%, 69.9% and 66.71% had coped with families by life style change whose monthly Tk. 20001-50000,Tk. 50001-100000, Tk. 10001-20000, Tk. 5000-10000 respectively. Coping ways in family by compromising treatment cost of other family members was minimum 0.0% within the income group Tk.5000-10000, which was statistically significant (p<0.05).Conclusion : The study concluded that the largest component of medical cost of IHD was the surgical cost which includes coronary angiogram, PTCA and bypass surgery. The patient compensate the burden of medical treatment cost of IHD from family savings, personal income, selling of property, personal loan, donation, health insurance and by Life style change, Reduction of food cost,and reducing social contact.Northern International Medical College Journal Vol.9(1) July 2017: 258-260

Comparison of Outpatient Harmonic Scalpel Tonsillectomy and Traditional Tonsillectomy in Sleep Disordered Breathing

ABSTRACT In this prospective study of 43 patients, 20 patients were operated by the outpatient harmonic scalpel tonsillectomy. The outpatient harmonic scalpel technique was performed by local injection with 2% Xylocaine with 1:80,000 adrenaline solution around palatine tonsils and using harmonic scalpel for dissecting tissue at superior pole until inferior pole of tonsil. Harmonic scalpel will cut and stop bleeding simultaneously and then, using plain catgut 3-0 ligation at the inferior pole of tonsil stops bleeding from tonsil branch of facial artery. All of the patients were followed up for 1 and 3 weeks postoperatively; 19 of 20 (95%) patients who were operated by the outpatient harmonic scalpel tonsillectomy felt satisfied and in one case, the patients wound healing delayed for 3 weeks. All patients were discharged on the day of admission with no major complication. Twenty-three patients were operated by the traditional tonsillectomy as an inpatient. Twenty of 23 (87%) patients were satisfied and in three cases, the patients had delayed wound healing for 3 weeks. The results of the study conclude that the outpatient harmonic scalpel tonsillectomy is satisfactory and medical treatment cost also is cheaper than the traditional tonsillectomy for the majority of patients. How to cite this article Chanvimalueng W. Comparison of Outpatient Harmonic Scalpel Tonsillectomy and Traditional Tonsillectomy in Sleep Disordered Breathing. Int J Otorhinolaryngol Clin 2016;8(1):18-21