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dc.contributor.authorToscano, Cristiana Mariapt_BR
dc.contributor.authorDuncan, Bruce Bartholowpt_BR
dc.contributor.authorMengue, Sotero Serratept_BR
dc.contributor.authorPolanczyk, Carisi Annept_BR
dc.contributor.authorNucci, Luciana Bertoldipt_BR
dc.contributor.authorForti, Adriana Costa ept_BR
dc.contributor.authorFonseca, Cláudio Duarte dapt_BR
dc.contributor.authorSchmidt, Maria Inêspt_BR
dc.date.accessioned2010-05-06T04:16:41Zpt_BR
dc.date.issued2006pt_BR
dc.identifier.issn1472-6963pt_BR
dc.identifier.urihttp://hdl.handle.net/10183/21616pt_BR
dc.description.abstractBackground: In 2001 Brazilian citizens aged 40 or older were invited to participate in a nationwide population screening program for diabetes. Capillary glucose screening tests and procedures for diagnostic confirmation were offered through the national healthcare system, diagnostic priority being given according to the severity of screening results. The objective of this study is to evaluate the initial impact of the program. Methods: Positive testing was defined by a fasting capillary glucose ≥ 100 mg/dL or casual glucose ≥ 140 mg/dL. All test results were tabulated locally and aggregate data by gender and clinical categories were sent to the Ministry of Health. To analyze individual characteristics of screening tests performed, a stratified random sample of 90,106 tests was drawn. To describe the actions taken for positive screenees, a random sub-sample of 4,906 positive screenees was actively followed up through home interviews. Main outcome measures considered were the number of diabetes cases diagnosed and cost per case detected and incorporated into healthcare. Results: Of 22,069,905 screening tests performed, we estimate that 3,417,106 (95% CI 3.1 – 3.7 million) were positive and that 346,168 (290,454 – 401,852) new cases were diagnosed (10.1% of positives), 319,157 (92.2%) of these being incorporated into healthcare. The number of screening tests needed to detect one case of diabetes was 64. As many cases of untreated but previously known diabetes were also linked to healthcare providers during the Campaign, the estimated number needed screen to incorporate one case into the healthcare system was 58. Total screening and diagnostic costs were US$ 26.19 million, the cost per diabetes case diagnosed being US$ 76. Results were especially sensitive to proportion of individuals returning for diagnostic confirmation. Conclusion: This nationwide population-based screening program, conducted through primary healthcare services, demonstrates the feasibility, within the context of an organized national healthcare system, of screening campaigns for chronic diseases. Although overall costs were significant, cost per new case diagnosed was lower than previously reported. However, cost-effectiveness analysis based on more clinically significant outcomes needs to be conducted before this screening approach can be recommended in other settings.en
dc.format.mimetypeapplication/pdfpt_BR
dc.format.mimetypeapplication/pdfpt_BR
dc.format.mimetypeapplication/zippt_BR
dc.language.isoengpt_BR
dc.relation.ispartofBMC health services research. London. Vol. 8, no. 189 (2008), p. 1-10.pt_BR
dc.rightsOpen Accessen
dc.subjectEpidemiologiapt_BR
dc.subjectDiabetes mellituspt_BR
dc.subjectBrasilpt_BR
dc.titleInitial impact and cost of a nationwide population screening campaign for diabetes in Brazil : a follow up studypt_BR
dc.typeArtigo de periódicopt_BR
dc.identifier.nrb000698937pt_BR
dc.type.originEstrangeiropt_BR


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