Objective: This study aimed to evaluate the cost-effectiveness of a group diabetes education program
delivered by health promoters in community health centers in the Western Cape, South Africa.
Methods: The effectiveness of the education program was derived from the outcomes of a pragmatic
cluster randomized controlled trial (RCT). Incremental operational costs of the intervention, as
implemented in the trial, were calculated. All these data were entered into a Markov micro-simulation
model to simulate clinical outcomes and health costs that were expressed as an Incremental Cost
Effectiveness Ratio (ICER).
Results: The only significant effect from the RCT at one year was a reduction in blood pressure (systolic
blood pressure 4.65 mmHg (95%CI:918 to 012) and diastolic blood pressure 3.30 mmHg
(95%CI:535 to 126)). The ICER for the intervention, based on the assumption that the costs would
recur every year and the effect could be maintained, was 1862 $/QALY gained.
Conclusion: A structured group education program performed by mid-level trained healthcare workers
at community health centers, for the management of Type II diabetes in the Western Cape, South Africa is
therefore cost-effective.
Practice implications: This cost-effectiveness analysis supports the more widespread implementation of
this intervention in primary care within South Africa.
2015 T
Objective: This study aimed to evaluate the cost-effectiveness of a group diabetes education programdelivered by health promoters in community health centers in the Western Cape, South Africa.Methods: The effectiveness of the education program was derived from the outcomes of a pragmaticcluster randomized controlled trial (RCT). Incremental operational costs of the intervention, asimplemented in the trial, were calculated. All these data were entered into a Markov micro-simulationmodel to simulate clinical outcomes and health costs that were expressed as an Incremental CostEffectiveness Ratio (ICER).Results: The only significant effect from the RCT at one year was a reduction in blood pressure (systolicblood pressure 4.65 mmHg (95%CI:918 to 012) and diastolic blood pressure 3.30 mmHg(95%CI:535 to 126)). The ICER for the intervention, based on the assumption that the costs wouldrecur every year and the effect could be maintained, was 1862 $/QALY gained.Conclusion: A structured group education program performed by mid-level trained healthcare workersat community health centers, for the management of Type II diabetes in the Western Cape, South Africa istherefore cost-effective.Practice implications: This cost-effectiveness analysis supports the more widespread implementation ofthis intervention in primary care within South Africa. 2015 T
การแปล กรุณารอสักครู่..