2型糖尿病初始甘精胰岛素患者移动医疗规范化综合管理模式的成本与效果分析

Cost-effectiveness analysis of a mobile health integrated management model among type 2 diabetes mellitus patients with initial glargine insulin treatment

目的评价利用"三位e体"移动医疗规范化综合管理模式在初始甘精胰岛素治疗的T2DM患者中开展BG管理的成本与效果。方法从血糖管理三人行项目中选取14229例经"三位e体"模式管理的T2DM患者作为试验(Exp)组,在基础胰岛素治疗观察登记性研究中选取经常规治疗的6801例患者作为对照(Con)组。利用患者BG达标情况评价治疗效果,结合患者医疗成本和管理成本进行成本与效果分析。结果12周随访结束时,Exp、Con组HbA1c、FPG较入组前均降低,且Exp组HbA1c和FPG达标率均高于Con组(P<0.01)。Exp、Con组管理总成本分别为1178元和1013元。Exp组HbA1c每下降1%的成本是393元,FPG每下降1 mmol/L的成本为203元,Con组分别为507元和274元。结论与常规基础胰岛素治疗相比,结合应用"三位e体"移动医疗管理模式显著提高T2DM患者BG控制效率及成本效果。

Objective To evaluate the cost-effectiveness of a standardized mobile health integrated management model for blood glucose control among type 2 diabetes mellitus(T2DM)patients with initial glargine insulin treatment in China.Methods selected as intervention group,and 6801 from ORBIT study as control.The treatment effectiveness of the management was evaluated by comparing the differences of changes in Hemoglobin A1c(HbA1c)and fasting plasma glucose(FPG)in two groups.The medical costs and management costs were used for cost-effectiveness analysis.control group.The rate of reaching target HbA1c and FPG in intervention group were significantly higher than those in control group(P<0.01).The total cost per patient was 1178 yuan in intervention group and 1013 yuan in control group,with HbA1c decrease of per 1%costing 393 yuan vs 507 yuan,and FPG decrease of per 1 mmol/L costing 203 yuan vs 274 yuan,prospectively.ConclusionMobile health T2DM management model can significantly improve efficiency of blood glucose control and cost-effectiveness of basal insulin treatment compare with the conventional treatment mode.