Janati Ali, Sarabchian Mohamad Ali, Mohaghegh Bahram, Aghmohamadzadeh Naser, Seyedin Hesam, Gholizadeh Masumeh, Hasanpoor Edris
Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.
Department of Internal Medicine, Faculty of Medicine, Endocrinology Research Center, Clinical Sciences Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
Ethiop J Health Sci. 2017 Nov;27(6):651-658. doi: 10.4314/ejhs.v27i6.10.
Type 2 Diabetes is a main concern of public health in contemporary world with remarkable mortality, delayed complications and health costs. Governments are obliged to improve the quality of health care and consider appropriate strategies to reduce the costs. An alternative strategy for hospital services is care at home. Therefore, this study was aimed to evaluate the cost-effectiveness of home-based and hospital-based diabetes care.
A quasi-experimental, pre-test and post-test design was conducted in Northwest Iran. Sixty subjects who were eligible insulin-treatment type 2 diabetes mellitus were randomly assigned into two equal groups to receive home-based or conventional hospital-based care. Data on glycosylated hemoglobin (HbA1c), hypoglycemia episodes, time needed to achieve glycemic control level, diabetes treatment satisfaction, diabetes knowledge and costs during three months were collected.
The cost of home-based care in insulin therapy diabetes was 61% less compared with the hospital-based methods. The former strategy was cost-effective in terms of reduction in HbA1C and the time needed to achieve glycemic control. The patients in home care group were more satisfied and knowledgeable.
The care at home approach for type 2 diabetic patients can be introduced and supported as a cost-effective care method in the country.
2型糖尿病是当代世界公共卫生的主要关注点，具有显著的死亡率、延迟并发症和医疗成本。政府有义务提高医疗保健质量并考虑采取适当策略以降低成本。医院服务的一种替代策略是居家护理。因此，本研究旨在评估居家糖尿病护理和医院糖尿病护理的成本效益。
在伊朗西北部进行了一项准实验性的前测和后测设计。将60名符合胰岛素治疗条件的2型糖尿病患者随机分为两组，每组人数相等，分别接受居家护理或传统的医院护理。收集了三个月内糖化血红蛋白（HbA1c）、低血糖发作次数、达到血糖控制水平所需时间、糖尿病治疗满意度、糖尿病知识和成本的数据。
胰岛素治疗糖尿病的居家护理成本比医院护理方法低61%。就降低HbA1C和达到血糖控制所需时间而言，前一种策略具有成本效益。居家护理组的患者更满意且知识更丰富。
对于2型糖尿病患者，居家护理方法可作为该国一种具有成本效益的护理方法加以推广和支持。
