{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T06:08:04Z","timestamp":1788847684527,"version":"build-2803163510"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior","doi-asserted-by":"publisher","award":["23038.007849\/2022-04"],"award-info":[{"award-number":["23038.007849\/2022-04"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Diabetes mellitus (DM) is one of the most common non-communicable diseases worldwide and is associated with a substantial increase in the healthcare burden due to high rates of morbidity, mortality, and long-term complications. Evidence on the economic impact of quality of care for diabetes management based on structured assessment indicators in real-world primary care settings is scarce. This study aimed to evaluate the cost-effectiveness of providing qualified care to individuals with diabetes in primary healthcare settings based on quality-of-care indicators.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cost-effectiveness analysis was conducted using a Markov based model from the perspective of a municipal health manager in Brazil. Data were collected from 114 patients aged 60\u2009years or older with type 2 diabetes mellitus in Vit\u00f3ria da Conquista. Patients were grouped based on whether 15 or more structured quality-of-care indicators were assessed during follow-up visits. The model simulated health state transitions over a 10-year time horizon, incorporating probabilities of complications, quality-adjusted life years, and direct costs. Sensitivity and probabilistic analyses were performed to test model robustness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Data mining techniques were used to identify a stronger association between the assessed items and a lower probability of having complications. It was found that in the group with 15 or more items assessed during visits, 17.4% had complications, and in the group with fewer than 15 items assessed during visits, this percentage was 37.14%. Therefore, these groups were used as comparators in the economic model. The cost-effectiveness analysis showed that the most comprehensive assessment was the dominant strategy, with an incremental cost-effectiveness ratio of -US$9742.51. The factors that most influenced the model were quality-adjusted life years, the probability of experiencing complications, and the cost of diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Qualified care with a comprehensive approach during follow-up visits was shown to be a cost-effective strategy for improving the quality of life for people with DM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/intqhc\/mzag098","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T11:34:30Z","timestamp":1784633670000},"source":"Crossref","is-referenced-by-count":0,"title":["Diabetes care guided by quality indicators: a cost-effectiveness analysis in the Brazilian public health system"],"prefix":"10.1093","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2274-6917","authenticated-orcid":false,"given":"Yasmin Vit\u00f3ria Andrade","family":"de Castro Alves","sequence":"first","affiliation":[{"name":"Multidisciplinary Institute of Health, University of Bahia (Post-graduate Program in Pharmaceutical Services and Policies) , Vit\u00f3ria da Conquista, Bahia, 45029-094,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e1rcio Galv\u00e3o","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Multidisciplinary Institute of Health, University of Bahia (Post-graduate Program in Pharmaceutical Services and Policies) , Vit\u00f3ria da Conquista, Bahia, 45029-094,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo R\u00e9gis Leira","family":"Pereira","sequence":"additional","affiliation":[{"name":"School of Pharmaceutical Sciences of Ribeir\u00e3o Preto, University of S\u00e3o Paulo , Ribeir\u00e3o Preto, S\u00e3o Paulo, 14040-903,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara de Souza","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Multidisciplinary Institute of Health, University of Bahia (Post-graduate Program in Collective Health) , Vit\u00f3ria da Conquista, Bahia, 45029-094,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priscila Ribeiro","family":"de Castro","sequence":"additional","affiliation":[{"name":"Multidisciplinary Institute of Health, University of Bahia (Post-graduate Program in Pharmaceutical Services and Policies) , Vit\u00f3ria da Conquista, Bahia, 45029-094,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erlan Cangu\u00e7u","family":"Aguiar","sequence":"additional","affiliation":[{"name":"Multidisciplinary Institute of Health, University of Bahia (Post-graduate Program in Pharmaceutical Services and Policies) , Vit\u00f3ria da Conquista, Bahia, 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