Quantifying and Mitigating the Burden of Non-Communicable Diseases in Kuwait
Unraveling the inter-dependencies of noncommunicable diseases and their burden and charting the economic implications of diabetes management, each study seeks to improve disease management and policies. The studies explore innovative methodologies and the transformative impact of mitigation strategies, all while striving for a more efficient and value-based healthcare system
Noncommunicable Diseases and Hospital Utilization in Kuwait: A Generalizable Approach Using the World Health SurveyPublished in Medical Principles and Practice and the London School of Economics Middle East Center Paper Series. Arabic version here
Kuwait and its neighboring Arabian Gulf countries are grappling with a rising prevalence of noncommunicable diseases (NCDs), which puts significant pressure on their healthcare systems and poses economic challenges.
This study aimed to quantify the hospital utilization risk in Kuwait related to the most common NCDs (excluding cancer) using a method that allows for cross-country disease burden comparisons and evaluations of prevention effectiveness.
Data was sourced from the 2010 World Health Survey in Kuwait, analyzing responses from 2,165 individuals with self-reported hospital admissions over a year and NCD diagnoses.
Hospital utilization rates were assessed for individuals diagnosed with conditions like hypertension, diabetes mellitus, asthma, chronic lung conditions, heart disease, and stroke, with adjustments made for demographic and socioeconomic factors.
Through negative binomial regressions, the study found that hypertension, the most prevalent NCD in Kuwait, led to a 75% increase in hospital utilization. Heart disease resulted in a staggering 495% rise in hospital utilization rates after accounting for potential confounding factors.
The study highlights the significant strain NCDs place on curative services in Kuwait. The methodology used offers a standardized approach to compare hospital utilization rates linked to various NCDs and can be applied to over 70 countries that took part in the World Health Survey.
Towards Value-Based Healthcare: Establishing Baseline Pharmacy Care Costs for Diabetes ManagementWith Yousef Abdulsalam, Salma Al Mutawa, Hashem Behbehani, Dari Alhuwail, Saud Al Jenaei
Published in The International Journal of Health Planning and Management
The global prevalence of diabetes has tripled in the past two decades, with the worldwide cost of diabetes mellitus exceeding one trillion USD in 2015, representing 1.8% of global GDP.
Prescription medications for diabetes complications account for nearly 30% of the total medical expenses related to the disease.
The study aimed to support value-based decision-making by analyzing the primary cost drivers of pharmacy services in a diabetes care institute. A flexible costing model was developed, considering both pharmaceutical and labor costs associated with pharmacy processes.
Data from electronic health records and observational studies were used to determine direct pharmaceutical costs and indirect labor costs at the activity level.
The yearly average cost of pharmacy services per diabetes patient was found to be 1246 USD. Of this, 98% was attributed to pharmaceutical expenses, while labor costs made up the remaining 2%.
The study's flexible costing model and findings are crucial for making value-based comparisons of interventions and care models. The presented costing approach and results have implications for advancing value-based healthcare delivery and provider payment models by enabling swift cost estimation, enhancing efficiency, and maximizing care value.
The Effect of Structured Diabetes Self-Management Education on Type 2 Diabetes Patients Attending a Primary Health Center in KuwaitWith Dalal AlRamadhan, Mahdi Alhashemi, Maryam Al-Hilal, Huda Al-Duwaisan
Published in Diabetes Research and Clinical Practice and presented at Academy Health Annual Research Meeting 2020
The study evaluates the impact of Diabetes Self Management Education (DSME) sessions on the control of Type 2 Diabetes in patients attending a primary health center in Kuwait.
Patients who underwent DSME sessions showcased improved diabetes control, with an average HbA1c reduction of 1.3% over 12 months. In contrast, the control group saw an average HbA1c increase of 1.1%.
Specific demographic groups, including younger patients, males, expatriates, and those with an HbA1c above 7%, exhibited the most significant improvements after DSME sessions.
Multivariate regression analysis revealed that DSME intervention correlated with a 1.7% HbA1c reduction, indicating enhanced diabetes management.
The study confirms the efficacy of DSME sessions for both Kuwaiti nationals and expatriates, a significant demographic in Kuwait and the Arabian Gulf region. The positive outcomes of DSME present a cost-effective strategy to mitigate diabetes-related complications, tailored to the region's unique demographic profile.
A Procurement-Based Classification of Pharmaceutical Supplies for Diabetes Disease ManagementWith Yousef Abdulsalam, Hashem Behbehani, Dari Alhuwail
Published in Health Science Reports
Diabetes is a leading noncommunicable chronic disease worldwide, with pharmaceutical supplies for its management constituting 20%–40% of the disease's overall management costs, a figure that's on the rise.
This study delves into the pharmaceutical costs linked to diabetes, aiming to gauge how patient health and demographic attributes influence the yearly expenses of diabetes-related pharmaceutical supplies.
A unique procurement-focused classification system was applied to the pharmaceutical items used in diabetes care.
Data was sourced from 98,648 pharmaceutical-dispensing transactions (pertaining to 2,828 patients) over a year from a specialized diabetes health center. To ensure broader applicability, pharmaceutical prices from the sample were benchmarked internationally.
The research found that a mere 20% of patients accounted for roughly 80% of the total pharmaceutical expenses. Notably, two pharmaceutical categories - anti-diabetes drugs and insulin - represented 34% of the dispensed products and 57% of the overall pharmaceutical costs.
The portfolio purchasing model indicated that certain clinically similar items, such as different insulin types, might benefit from varied procurement strategies or vendors to maximize cost efficiency.
By comprehending the wide range of diabetes supplies, there's potential for improved strategic supply management. The supply classification method introduced in this study can also be beneficial in other specialties with significant supply needs, like orthopedics.
Diabetes Patient Phenotypes in Kuwait: A Clustering ApproachWith Dalal AlRamadhan, Hashem Behbehani, Yousef Abdulsalam, Thamer Alessa, Dari Alhuwail
Presented at Academy Health Annual Research Meeting 2021, manuscript being prepared
The Gulf Cooperation Council (GCC) countries allocate a significant portion of their healthcare budget to diabetes care, especially for patients with multiple chronic conditions, due to the region's notably high diabetes prevalence.
Given the diverse demographics and the variety of comorbidities present, managing diabetes in the region presents unique challenges.
This study utilized clustering algorithms to pinpoint specific subgroups of diabetes patients at higher risk of complications, considering factors like health status, demographics, and healthcare utilization. The goal is to enable more personalized care and intervention strategies.
Data from 3,538 patients from a diabetes institute was analyzed, considering variables such as diabetes type, age, BMI, and medication specifics.
Four unique patient clusters were identified, with the presence and nature of comorbidities serving as key differentiators among these groups. The clusters revealed increasing trends in age, chronic conditions, and medication costs.
By understanding these clusters, healthcare professionals can craft specialized intervention strategies, particularly targeting the prevention of comorbidities like cardiovascular, gastrointestinal, and urological issues. This tailored approach promotes more effective care and contributes to a more streamlined healthcare system in the GCC.