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4.3.4 METHODOLOGY

Parallel to previously published studies on RAMP-DM care in Hong Kong, our BIA will focus
on direct costs to the health system related to cost of hospitalisation, GOPC visits, SOPC
visits, allied health clinic visits, and A&E department visits across the public and private
sectors (Jiao et al., 2017).

Target screening population and epidemiological data

The Scheme aims to screen all individuals between the ages of 45–54 years
for DM and prediabetes. To estimate the prevalence of DM and prediabetes amongst
the target population to screen, we retrieved population data and disease epidemiological
data based on age stratification from the latest 2014/15 PHS from the CHP (CHP, 2017).

Inclusion criteria

The Scheme will be inclusive of all individuals between the ages of 45 and 54 years in the
first year of implementation and who are eligible to receive public healthcare services at the
Government-subsidised price point (e.g. Hong Kong Permanent Residents and HK identity
card (HKID) holders). Individuals who have previously received a positive diagnosis for DM
will be included in the model to account for those who may wish to receive an additional
series of screening tests to confirm their diagnosis and/or to partake in the additional
management components of the Scheme. Within the Scheme projection, we did not
distinguish between individuals with prior diagnoses and individuals with DM but without
prior diagnoses. The model will project the costs and savings of those who qualify
at the start of the study and track the spending of this demographic
group over a time horizon of 30 years.

Exclusion criteria

The Scheme excludes those aged 55 years and over, as well as those under the age of 45 at
the start of the study period. While research shows that older adults (individuals aged ≥ 65)
are faced with an increased prevalence of DM relative to a younger population (individuals
aged 18–64), the Scheme will exclude individuals aged 55 years and over at the
start of the programme due to two principal reasons: a) to capture the benefits of the
Scheme at an age (i.e., 45 years of age) that is underserved in prevention programmes,
which can generate a better understanding of the economic and health benefit of promoting
earlier interventions for chronic diseases; b) to avoid insufficient reliable data on DM for those
aged 85 years and above (Wong et al., 2017).

Within our projection model parameters, we expect that our target demographic will reach
the ages of 75–84 years at the end of the 30-year time horizon. While existing programmes
may have already captured segments of this population and will provide similar services, our
model intends to show a long-term and population-wide spending projection for 30 years of
regular screening and management for DM. As such, the target age range being 45–54 at
the start of the study period allows for an extended duration capturing this specific age
period during which there are high risks for developing DM-related complications.

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