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...

Descripción completa

Detalles Bibliográficos
Publicado en:Disease Management & Health Outcomes Vol. 14; no. 6; pp. 377 - 386
Autores principales: Mason JM, Young RJ, New JP, Gibson JM, Long AF, Gambling T, Friede T
Formato: equations & formulas research tables/charts Journal Article
Publicado: Springer Nature Dec2006
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