Background.Diabetic retinopathy(DR)has been primarily indicated to cause vision impairment and blindness,while no studies have focused on the cost-utility of telemedicine-based and community screening programs for DR ...Background.Diabetic retinopathy(DR)has been primarily indicated to cause vision impairment and blindness,while no studies have focused on the cost-utility of telemedicine-based and community screening programs for DR in China,especially in rural and urban areas,respectively.Methods.We developed a Markov model to calculate the cost-utility of screening programs for DR in DM patients in rural and urban settings from the societal perspective.The incremental cost-utility ratio(ICUR)was calculated for the assessment.Results.In the rural setting,the community screening program obtained 1 QALY with a cost of$4179(95%CI 3859 to 5343),and the telemedicine screening program had an ICUR of$2323(95%CI 1023 to 3903)compared with no screening,both of which satisfied the criterion of a significantly cost-effective health intervention.Likewise,community screening programs in urban areas generated an ICUR of$3812(95%CI 2906 to 4167)per QALY gained,with telemedicine screening at an ICUR of$2437(95%CI 1242 to 3520)compared with no screening,and both were also cost-effective.By further comparison,compared to community screening programs,telemedicine screening yielded an ICUR of 1212(95%CI 896 to 1590)per incremental QALY gained in rural setting and 1141(95%CI 859 to 1403)in urban setting,which both meet the criterion for a significantly cost-effective health intervention.Conclusions.Both telemedicine and community screening for DR in rural and urban settings were cost-effective in China,and telemedicine screening programs were more cost-effective.展开更多
基金the Major Innovation Platform of Public Health&Disease Control and Prevention,Renmin University of China,and Beijing Nova Program(Z191100001119072).
文摘Background.Diabetic retinopathy(DR)has been primarily indicated to cause vision impairment and blindness,while no studies have focused on the cost-utility of telemedicine-based and community screening programs for DR in China,especially in rural and urban areas,respectively.Methods.We developed a Markov model to calculate the cost-utility of screening programs for DR in DM patients in rural and urban settings from the societal perspective.The incremental cost-utility ratio(ICUR)was calculated for the assessment.Results.In the rural setting,the community screening program obtained 1 QALY with a cost of$4179(95%CI 3859 to 5343),and the telemedicine screening program had an ICUR of$2323(95%CI 1023 to 3903)compared with no screening,both of which satisfied the criterion of a significantly cost-effective health intervention.Likewise,community screening programs in urban areas generated an ICUR of$3812(95%CI 2906 to 4167)per QALY gained,with telemedicine screening at an ICUR of$2437(95%CI 1242 to 3520)compared with no screening,and both were also cost-effective.By further comparison,compared to community screening programs,telemedicine screening yielded an ICUR of 1212(95%CI 896 to 1590)per incremental QALY gained in rural setting and 1141(95%CI 859 to 1403)in urban setting,which both meet the criterion for a significantly cost-effective health intervention.Conclusions.Both telemedicine and community screening for DR in rural and urban settings were cost-effective in China,and telemedicine screening programs were more cost-effective.
