COVID-19 パンデミックを超えて:タイにおける高血圧および糖尿病管理のための遠隔医療の予算影響分析
Jongkonnee Chongpornchai1,2, Tuangrat Phodha1, Thanawat Wongphan3,4
1Drug Information and Consumer Protection Center, Center of Excellence in Pharmacy Practice and Management Research, Faculty of Pharmacy, Thammasat University, Pathum Thani, Thailand.
ClinicoEconomics and outcomes research : CEOR
|September 5, 2025
まとめ
高血圧 (HT) や糖尿病 (DM) の患者に対する自宅での薬局 (PAH) や延期ケア (DC) のようなリモートヘルスケアの経路を導入することで,タイ政府は資金を節約しました. これらの革新的なモデルは,COVID-19のパンデミック期間およびその後の通常のケア (UC) に比べて費用対効果が高いことが証明されました.
科学分野:
- 健康 経済
- 医療管理
- 公衆衛生政策
背景:
- COVID-19 パンデミックにより,非伝染性疾患に対する新しい医療提供モデルが必要になりました.
- 家庭での薬局 (PAH) と延期ケア (DC) を含む遠隔医療は,安定した高血圧 (HT) と糖尿病 (DM) の管理のための解決策として登場しました.
研究 の 目的:
- タイの高等保健病院で,通常診療 (UC) と比べ,PAHとDCの実施による予算効果を推定する.
- 政府の観点からコストを分析する.
主な方法:
- 2021年7月〜12月 (COVID-19) と2022年7月〜12月 (新常態) を比較して,遡及的な予算影響分析が行われました.
- 費用は多変数ログ線形回帰を用いて推定された.
- シナリオは,ベースライン (UCのみ) と代替 (UC+PAH+DC) を比較し,感度分析を行った.
主要な成果:
- 代替シナリオ (UC+PAH+DC) では,両期間の総コストが低下し,COVID-19 期間中に710万米ドル,新正規期には610万米ドルを節約した.
- 費用削減比率は,割り当てられた1ドルあたりそれぞれ0.06ドルと0.05ドルであった.
- 感受性分析は,これらの発見の確固たるものであることを確認した.
結論:
- 家庭での薬局 (PAH) と延期ケア (DC) の経路は経済的に有利で,政府の観点から重要なコスト削減を示しています.
- これらの発見は,リソースが限られた環境での遠隔医療の実施を支持します.
- 社会的観点と患者の観点を考慮した更なる包括的な評価が推奨され,エクストラポレーションとパラメータの変動性のために注意を払うことをお勧めします.
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