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Rationale and protocol for estimating the economic value of a multicomponent quality improvement strategy for diabetes care in South Asia

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Global Health Research and Policy 2019年第1期4卷 333-342页

作者： Kavita Singh Mohammed KAli Raji Devarajan Roopa Shivashankar Dimple Kondal Vamadevan S.Ajay VUsha Menon Premlata KVarthakavi Vijay Viswanathan Mala Dharmalingam Ganapati Bantwal Rakesh Kumar Sahay Muhammad Qamar Masood rajesh khadgawat Ankush Desai Dorairaj Prabhakaran K.M.Venkat Narayan Victoria LPhillips Nikhil Tandon On behalf of the CARRS Trial Group Public Health Foundation of India Center of Excellence-Center for CArdio-metabolic Risk Reduction in South Asia4th FloorPlot No.47Sector 44Institutional AreaGurgaonHaryana 122002India Rollins School of Public Health Emory University1518 Clifton RoadRm CNR 7041AtlantaGA 30322USA Department of Endocrinology&Diabetes Amrita Institute of Medical SciencesAmrita Vishwa VidyapeethamPonekkara P.O.KochiKerala 682041India Department of Endocrinology TNM College&BYL Nair Charity HospitalDr.A.L.Nair RoadMumbai CentralMumbaiMaharashtra 400008India MV Hospital for Diabetes&Diabetes Research Centre No 4West Madha Church StreetRoyapuramChennaiTamil Nadu 600013India Bangalore Endocrinology&Diabetes Research Centre #355th CrossMalleswaram CircleBangaloreKarnataka 560003India Department of Endocrinology St.John’s Medical College&HospitalSarjapur RoadKoramangalaBangaloreKarnataka 560034India Department of Endocrinology Osmania General Hospital2nd FloorGolden Jubilee BlockAfzalgunjHyderabadTelangana 500012India Department of Medicine Section of Endocrinology and DiabetesAga Khan UniversityStadium RoadKarachi 74800Pakistan Department of Endocrinology&Metabolism All India Institute of Medical SciencesBiotechnology Block3rd FloorAnsari NagarNew Delhi 110029India Endocrine Unit Department of MedicineGoa Medical CollegeBambolimGoa 403202India Public Health Foundation of India 4th FloorPlot No.47Sector 44Institutional AreaGurgaonHaryana 122002India Rollins School of Public Health Emory University1518 Clifton RoadRm CNR 7049AtlantaGA 30322USA Rollins School of Public Health Emory University1518 Clifton RoadAtlantaGA 30322USA Department of Endocrinology&Metabolism All India Institute of Medical SciencesBiotechnology Block3rd FloorRm#312Ansari NagarNew Delhi 110029India Centre for Chronic Disease Control C 1/52Second FloorSafdarjung Development AreaNew Delhi110016India London School of Hygiene and Tropical Medicine Keppel StBloomsburyLondon WC1E 7HTUK. 不详

Background:Economic dimensions of implementing quality improvement for diabetes care are understudied *** describe the economic evaluation protocol within a randomised controlled trial that tested a multicomponent quality improvement(QI)strategy for individuals with poorly-controlled type 2 diabetes in South ***/design:This economic evaluation of the Centre for Cardiometabolic Risk Reduction in South Asia(CARRS)randomised trial involved 1146 people with poorly-controlled type 2 diabetes receiving care at 10 diverse diabetes clinics across India and *** economic evaluation comprises both a within-trial cost-effectiveness analysis(mean 2.5 years follow up)and a microsimulation model-based cost-utility analysis(life-time horizon).Effectiveness measures include multiple risk factor control(achieving HbA1c<7%and blood pressure<130/80 mmHg and/or LDL-cholesterol<100 mg/dl),and patient reported outcomes including quality adjusted life years(QALYs)measured by EQ-5D-3 L,hospitalizations,and diabetes related complications at the trial *** measures include direct medical and non-medical costs relevant to outpatient care(consultation fee,medicines,laboratory tests,supplies,food,and escort/accompanying person costs,transport)and inpatient care(hospitalization,transport,and accompanying person costs)of the intervention compared to usual diabetes ***,healthcare system,and societal perspectives will be applied for *** cost and health effects will be discounted at 3%per year for within trial cost-effectiveness analysis over 2.5 years and decision modelling analysis over a lifetime *** will be reported as the incremental cost-effectiveness ratios(ICER)to achieve multiple risk factor control,avoid diabetes-related complications,or QALYs gained against varying levels of willingness to pay threshold *** analyses will be performed to assess uncertainties around ICER estimates by varying costs(95%CIs)across publ

关键词： Economic evaluation Diabetes care Multicomponent strategy Quality improvement South Asia

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