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  The Economic and Clinical Outcome of Increased Physical Activity among People with Type 2 Diabetes in China
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 Ophav:
Wilkinson, Lars1, Forfatter
Nørtoft, Emil1, Forfatter
Østerdal, Lars Peter Raahave2, Vejleder
Tilknytninger:
1Det Samfundsvidenskabelige Fakultet, Københavns Universitet, København, Danmark, diskurs:7001              
2Økonomisk Institut, Det Samfundsvidenskabelige Fakultet, Københavns Universitet, København, Danmark, diskurs:7014              
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Indhold

Ukontrollerede emneord: Health economics, cost-utility analysis, propensity score matching, China, diabetes, population model, physical activity, exercise and Markov model.
 Abstract: Exercise is a cornerstone in diabetes self-management since several studies have shown that physical activity has a positive effect on the level of blood glucose (the main indicator of diabetes) and the other diabetes related risk factors. Although there is a broad consensus that increased physical activity has a beneficial effect, only 60% of the people who are diagnosed with type 2 diabetes in China report that they exercise regularly. This means that 40% of the people with type 2 diabetes in China do either rarely or not exercise at all. During the last decade, several studies have focused on interventions, which may increase the level of physical activity. One of the most comprehensive interventions is the Green Prescription (GP) program, which has previously been found to increase the physical activity among the participants. In this thesis we want to determine the economic and clinical outcome of an introduction of the GP program in China, specifically targeting the people with type 2 diabetes who do not exercise regularly.
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Emil.pdf (Hovedtekst)
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Tilgængelighed:
Offentlig
Mime-type / størrelse:
application/pdf / 11MB
Copyright dato:
2013-10-10
Copyright information:
De fulde rettigheder til dette materiale tilhører forfatteren.
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Basal

Bogmærk denne post: https://diskurs.kb.dk/item/diskurs:52910:1
 Type: Speciale
Alternativ titel: De Økonomiske og Kliniske Konsekvenser af Øget Fysisk Aktivitet blandt Type 2 Patienter
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Detaljer

Sprog: English - eng
 Datoer: 2013-09-07
 Sider: -
 Publiceringsinfo: København : Københavns Universitet
 Indholdsfortegnelse: 1 Introduction 1
1.1 Objective 2
1.2 Limitations . 3
1.3 Structure of the analysis 4
2 Background 7
2.1 Type 2 diabetes and its complications . 7
2.1.1 The pathophysiology of type 2 diabetes 7
2.1.2 The long-term diabetes related complications 8
2.2 Type 2 diabetes in China 9
2.2.1 The prevalence . 10
2.2.2 The economic burden of diabetes . 11
2.3 Managing type-2 diabetes and HbA1c . 12
2.3.1 Diabetes management in practice . 12
2.3.2 The goals in diabetes management 12
2.4 Exercise and diabetes related risk factors . 14
2.4.1 Systematic literature review on the e↵ect of exercise in China . 15
2.5 Exercise in diabetes management in China 18
2.6 Green Prescription (GP) program . 19
3 Data 23
3.1 The design of the survey 23
3.1.1 Handling missing observation and cleansing data . 25
3.1.2 Variable creation 25
3.2 Descriptive presentation 26
3.2.1 Individual level risk factors . 26
3.2.2 Management of diabetes in China . 29
4 The e↵ect of regular exercise on diabetes related risk factors 31
4.1 Methods to estimate the average treatment e↵ect of regular exercise 31
4.1.1 In the case of non-randomized data 32
4.1.2 Propensity score matching . 34
4.2 Estimating the ATE of regular exercise 35
4.2.1 The first-stage: the propensity score model 36
4.2.2 The second-stage: matching 39
4.3 Sensitivity analysis . 50
4.4 Discussion 53
4.5 Summary 55
5 An economic evaluation of the GP program in China 57
5.1 Methods in health economic evaluations . 57
5.1.1 Utility measure and quality-adjusted-life-years (QALYs) 58
5.1.2 Scenarios and assumptions . 60
5.1.3 Perspective of the analysis . 61
5.1.4 Discounting and time horizon . 62
5.1.5 Methods in estimating the costs and utilities . 62
5.2 Modeling type 2 diabetes 64
5.2.1 Existing type 2 diabetes models 66
5.2.2 Choice of existing type 2 diabetes model . 69
5.3 The CORE Diabetes Model 69
5.3.1 The structure of the CORE Diabetes Model . 70
 Note: -
 Type: Speciale
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