在印度的初级卫生中心优化糖尿病视网膜病症查:成本效益分析
Neha Purohit1, Parul Chawla Gupta2, Sandeep Buttan3
1Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Sector-12, Chandigarh, 160012, India.
PharmacoEconomics - open
|April 9, 2025
概括
远程支持的糖尿病视网膜病变 (DR) 查是印度最具成本效益的策略. 这种方法针对糖尿病患者5年或更长时间,显著减少视力丧失和失明.
科学领域:
- 眼科医生 眼科 眼科
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
背景情况:
- 印度的Ayushman Bharat计划包括在初级卫生中心每年进行糖尿病视网膜病变 (DR) 查.
- 对于系统的DR查计划,存在各种实施模型.
研究的目的:
- 评估DR查与常规护理之间的成本效益.
- 在印度的初级卫生中心确定年度DR查的最佳实施策略.
主要方法:
- 开发了一个数学模型 (决策树和马尔科夫模型).
- 文献审查和初级数据收集用于参数导出.
- 进行了增量成本效益比率 (ICER) 和灵敏度分析.
主要成果:
- 所有的年度查策略都比常规护理更具成本效益.
- 电话支持的糖尿病查持续时间≥5年具有最低的ICER (每QALY₹57,408/$730).
- 这一战略可以在全国范围内将视力威胁的DR和失明减少17.3%和38.5%.
结论:
- 优先考虑印度的年度远程支持的DR查计划.
- 整合眼睛护理与糖尿病护理,以更好地控制血糖和早期发现DR.
- 人工智能支持的查可能会变得具有成本效益,改善血糖控制.
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