title: The long-term effect of community-based health management on the elderly with type 2 diabetes by the Markov modeling.
abstract: The aim of this study was to assess the long-term effects of community-based health management on elderly diabetic patients using a Markov model. A Markov decision model was used to simulate the natural history of diabetes. Data were obtained from our randomized trials of elderly with type 2 diabetes and from the published literature. One hundred elderly patients with type 2 diabetes were randomly allocated to either the management or the control group in a one-to-one ratio. The management group participated in a health management program for 18 months in addition to receiving usual care. The control group only received usual care. Measurements were performed on both groups at baseline and after 18 months. The Markov model predicted that for every 1000 diabetic patients receiving health management, approximately 123 diabetic patients would avoid complications, and approximately 37 would avoid death over the next 13 years. The results suggest that the health management program had a positive long-term effect on the health of elderly diabetic patients. The Markov model appears to be useful in health care planning and decision-making aimed at reducing the financial and social burden of diabetes.
authors.affiliation: Department of Medical Insurance, School of Public Health, Southeast University, Nanjing, Jiangsu, China.
authors.forename: Jianqian
authors.initials: J
authors.lastname: Chao
authors.affiliation: Department of Medical Insurance, School of Public Health, Southeast University, Nanjing, Jiangsu, China.
authors.forename: Mengmeng
authors.initials: M
authors.lastname: Zong
authors.affiliation: Hospital of Qinghuai, Nanjing, Jiangsu, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Xu
authors.affiliation: Hospital of Qinghuai, Nanjing, Jiangsu, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Yu
authors.affiliation: Department of Medical Insurance, School of Public Health, Southeast University, Nanjing, Jiangsu, China.
authors.forename: Lili
authors.initials: L
authors.lastname: Jiang
authors.affiliation: Department of Medical Insurance, School of Public Health, Southeast University, Nanjing, Jiangsu, China.
authors.forename: Yunyun
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Medical Insurance, School of Public Health, Southeast University, Nanjing, Jiangsu, China.
authors.forename: Long
authors.initials: L
authors.lastname: Song
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, Jiangsu, China. Electronic address: chaoseu@163.com.
authors.forename: Pei
authors.initials: P
authors.lastname: Liu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002681:China; D003153:Community Health Services / Q000458:organization & administration*; D003657:Decision Making; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy*; D005260:Female; D006302:Health Services Research; D006801:Humans; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010347:Patient Care Planning; D011795:Surveys and Questionnaires
keywords: Elderly diabetic patients; Health management; Long-term effect; Markov model