OBJECTIVE -To estimate the health-related quality of life (HRQOL) and treatment satisfaction for patients with type 2 diabetes in the Netherlands and to examine which patient characteristics are associated with quality of life and treatment satisfaction. RESEARCH DESIGN AND METHODS-For a sample of 1,348 type 2 diabetes patients, recruited by 29 general practitioners, we collected data regarding HRQOL. This study was performed as part of a larger European study (Cost of Diabetes in Europe -Type 2 [CODE-2]). We used a generic instrument (Euroqol 5D) to measure HRQOL. Treatment satisfaction was assessed using the Diabetes Treatment Satisfaction Questionnaire.RESULTS -Patients without complications had an HRQOL (0.74) only slightly lower than similarly aged persons in the general population. Insulin therapy, obesity, and complications were associated with a lower HRQOL, independent of age and sex. Although higher fasting blood glucose and HbA 1c levels were negatively associated with HRQOL, these factors were not significant after adjustment for other factors using multivariate analysis. Overall treatment satisfaction was very high. Younger patients, patients using insulin, and patients with higher HbA 1c levels were less satisfied with the treatment than other patients.CONCLUSIONS -Obesity and the presence of complications are important determinants of HRQOL in patients with type 2 diabetes. Diabetes Care 25:458 -463, 2002T ype 2 diabetes is a chronic disease that affects a patient's general health and well-being in various ways. For example, severe dietary restriction and daily self-administration of oral medications or insulin may adversely affect an individual's health-related quality of life (HRQOL). In addition, the long-term complications of diabetes, such as nephropathy, neuropathy, heart disease, and stroke, with their considerable impact on health, may also have a negative effect on quality of life, as shown in the U.K. Prospective Diabetes Study (UKPDS) study and a recent review (1,2).The aim of this study was to determine the HRQOL and treatment satisfaction for patients with type 2 diabetes in the Netherlands and to examine which patient characteristics are associated with quality of life and treatment satisfaction. This study was initiated as part of the Cost of Diabetes in EuropeType 2 (CODE-2) study, a large study of type 2 diabetes patients in eight European countries (3,4). RESEARCH DESIGN AND METHODSThe CODE-2 study The CODE-2 study was performed to provide comprehensive data on costs and quality of life and involved 7,635 patients in eight European countries. Full details have been presented by Jonsson et al. (3).A sample of Dutch type 2 diabetes patients, recruited by a representative sample of 29 Dutch general practitioners, completed questionnaires regarding quality of life and treatment satisfaction. Information regarding medical costs was also collected and has already been reported (5). The general practitioners, randomly selected from a computerized database, identified all type 2 diabetic...

The societal perspective in economic evaluations dictates that costs and effects of informal care are included in the analyses. However, this incorporation depends on practically applicable, reliable and valid methods to register the impact of informal care. This paper presents the conceptualisation and a first test of the CarerQol instrument, aimed at measuring care-related quality of life in informal caregivers. The instrument combines the information density of a burden instrument (encompassing seven important burden dimensions) with a valuation component (a VAS scale for happiness). The instrument was tested in a Dutch sample of heterogeneous caregivers (n=175) approached through regional caregiver support centres. This first test describes the feasibility as well as convergent and clinical validity of the CarerQol instrument. The seven burden dimensions related well with differences in VAS scores. In all instances, the average CarerQol-VAS scores decreased as the severity of problems increased. Multivariate analyses showed that the seven burden dimensions explained 37-43% of the variation in CarerQol-VAS scores, depending on the model used. The CarerQol seems a promising new instrument to register the impact of informal caregivers in economic evaluations.

The aim of the study was to determine whether the total cost estimate of a hospital service remains reliable when the cost components of bottom-up microcosting were replaced by the cost components of top-down microcosting or gross costing. Total cost estimates were determined in representative general hospitals in the Netherlands for appendectomy, normal delivery, stroke and acute myocardial infarction for 2005. It was concluded that restricting the use of bottom-up microcosting to those cost components that have a great impact on the total costs (i.e., labour and inpatient stay) would likely result in reliable cost estimates.