Research Focus
As rising longevity and declining fertility rates drive population aging around the world, health systems confront the challenge of promoting healthy aging. Reducing the complications associated with chronic diseases like diabetes is critical to addressing this challenge. Since 1980, the burden of diabetes, both in terms of prevalence and number of adults affected, has increased at a greater rate in low-income and middle-income countries than in high-income countries. About 80% of adults with diabetes today live in low-to-middle income countries, with the largest increase in absolute numbers in East Asia and South Asia.
The Net Value in Diabetes Management research project, led by Shorenstein APARC’s Asia Health Policy Program (AHPP), compares health care use, medical spending, and clinical outcomes for patients with diabetes in Asia and other parts of the world as a lens for understanding the economics of caring for patients with complicated chronic diseases across diverse health systems.
This international collaborative research brings together teams of clinicians and health economists in ten health systems (and growing): China, Hong Kong, India, Indonesia, Japan, Singapore, South Korea, and Taiwan, as well as the United States and The Netherlands. Together, the teams analyze big data—detailed, longitudinal patient-level information for large samples from each country, including millions of records of clinical encounters, health-check-up, and medical spending—to compare the health care use and patient outcomes for adults with type 2 diabetes in their health systems. The teams draw on previous methods for assessing net value as discussed in a 2009 study co-authored by Karen Eggleston, the project’s principal investigator and AHPP director.
The project aims to quantify the quality improvement associated with changes in medical technology, and to provide an evidence base for policies to improve the delivery of quality, cost-effective diabetes management coordinated across outpatient and inpatient settings. It contributes to each multidisciplinary team’s input for learning healthcare systems, as well as to health economics research on value for money across distinctive health service delivery systems.
The project is part of a broader research agenda seeking to assess productivity in health care with appropriate adjustments for quality. It has led to an extended study that is specifically focused on health policy reforms and chronic disease management in India and China (funded by the Stanford Center at Peking University).
