Economic evaluation of the management for diabetes mellitus

1)开发系统模型，进行糖尿病临床进展的模拟。500个虚构的病人（分别根据性别和年龄）被包括在这个系统模型中。此外，加上一般死亡率和糖尿病并发症引起的血管障碍死亡率的情况是通过给定事件随机产生的条件来计算的。用系统模型计算的按性别和年龄分类的生存概率与实际测量结果基本一致。因此，很明显，我们的模型具有灵活性。2)糖尿病并发症为多重的概率产生了暂时的表达，并以并发症的独立性和依赖性系数进行推定。当以0-1计算独立性和从属等级时，例如视网膜病变和神经病变的独立性和从属等级为0.61。对于每种复杂情况的发生概率，由于用这种独立从属的程度代替了系统模型，使得模型更加精确。3)根据系统模型，糖尿病医疗的成本效益比为0.30（男性和女性，所有年龄段），成本/质量年为177万日元。40 ~ 44岁的预期寿命和QALYs分别为男性28.0岁（普通组36.1岁）、22.9岁，女性33.3岁（普通组39.7岁）、25.2岁。

1)We developed the system model for carrying out the simulation of the diabetic clinical progress. 500 fictitious patients (according to a sex and age, respectively) were included in this system model. Furthermore, the case where general mortality rate and the mortality rate by the blood vessel obstacle by diabetic complications were added was calculated by having given the conditions which an event generates at random. The probability of survival according to a sex and age class as a result of the calculation using the system model was mostly in agreement with the actual measurement. Therefore, it became clear that our model has flexibility.2)The probability that diabetic complications are plurality creates expression temporarily, and is presumed with the coefficient of independence and dependence of complications. When independence and this subordinate grade were calculated in 0-1, the independent and subordinate grade of retinopathy and neuropathy was 0.61, for example. About the occurrence probability of each complication, since it substituted for the system model using this independent and subordinate extent, the model became more exact.3)According to the system model, the cost/benefit ratio of diabetes medical treatment was 0.30 (man and woman, all age), and the cost/QALYs was 1,770,000 yen. The life expectancy of 40-44 years old and QALYs were male: 28.0 (general group 36.1), 22.9, and female: 33.3 (general group 39.7) or 25.2 years.