Economic analysis of a telemedicine intervention to improve glycemic control in patients with diabetes mellitus: illustration of a novel analytic method.
Background and objective: An economic analysis of telemedicine support to improve glycemic control in patients with type 2 diabetes mellitus, illustrating the use of an analytic framework that efficiently combines telemedicine program findings with published estimates of treatment cost effectiveness...
| Publicado en: | Disease Management & Health Outcomes Vol. 14; no. 6; pp. 377 - 386 |
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| Autores principales: | , , , , , , |
| Formato: | equations & formulas research tables/charts Journal Article |
| Publicado: |
Springer Nature
Dec2006
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105970453&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105970453 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 11738790 C4Y jtl: Disease Management & Health Outcomes issn: 11738790 maglogo: N pubinfo: dt: Dec2006 vid: 14 iid: 6 pid: 87227 pub: Springer Nature artinfo: ui: 105970453 105970453 2009513837 10.2165/00115677-200614060-00007 105970453 ppf: 377 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Economic analysis of a telemedicine intervention to improve glycemic control in patients with diabetes mellitus: illustration of a novel analytic method. aug: au: Mason JM Young RJ New JP Gibson JM Long AF Gambling T Friede T affil: School for Health, Wolfson Research Unit, University of Durham, Queen's Campus, University Boulevard, Stockton-on-Tees, TS17 6BH, England; j.m.mason@durham.ac.uk sug: subj: Diabetes Mellitus, Type 2 Glycemic Control Telemedicine Economics Aged Confidence Intervals Cost Benefit Analysis Descriptive Statistics Funding Source Middle Age P-Value Quality of Life Sensitivity and Specificity Human Aged: 65+ years Middle Aged: 45-64 years ab: Background and objective: An economic analysis of telemedicine support to improve glycemic control in patients with type 2 diabetes mellitus, illustrating the use of an analytic framework that efficiently combines telemedicine program findings with published estimates of treatment cost effectiveness.Method: The Pro-Active Call Centre Treatment Support (PACCTS) trial compared tailored, protocol-driven call-center support with usual care as methods to manage glycemic control in 591 patients with diabetes in Salford, UK. Economic analysis of the trial describes the cost of delivering telemedicine support and level of improved glycemic control achieved in patients. These findings are linked to current best evidence for the long-term cost effectiveness of treatment to help inform whether the provision of call-center support to improve glycemic control should become routine health policy.Results: Under trial conditions, the cost effectiveness of the PACCTS intervention was estimated to be [pounds]43 400/quality-adjusted life-year (QALY) [2003 costings]. Under routine-use call-center conditions (a full caseload of patients with moderate to poor glycemic control) cost effectiveness was estimated to be lower at [pounds]33 700/QALY. Set against a threshold of [pounds]30 000/QALY, Monte Carlo simulation suggests the probability of PACCTS being cost-effective in routine use is 29%.Discussion: Despite being received well by patients and healthcare professionals alike, telemedicine support solely to achieve improved glycemic control in patients with type 2 diabetes was found to be borderline cost effective. Major uncertainties that could change this result include the underlying cost effectiveness of improved glycemic control, which is currently imprecisely known. Research is ongoing in patients with type 2 diabetes to extend call-center support to improve blood pressure and lipid management, where if similar improvements are obtained, the call center should prove highly cost effective. The novel analytic approach illustrated provides a clear framework for thinking about the design and analysis of behavioral change policies for healthcare. pubtype: Academic Journal doctype: equations & formulas research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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