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新型冠状病毒肺炎对糖尿病护理的卫生经济学和技术的影响:实时连续血糖监测在全球大流行期间改变医疗保健的应用实例。

Impact of COVID-19 on Health Economics and Technology of Diabetes Care: Use Cases of Real-Time Continuous Glucose Monitoring to Transform Health Care During a Global Pandemic.

机构信息

Western Digital Corp., San Jose, California, USA.

Dexcom, Inc., San Diego, California, USA.

出版信息

Diabetes Technol Ther. 2021 Mar;23(S1):S15-S20. doi: 10.1089/dia.2020.0656.

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has exposed vulnerabilities and placed tremendous financial pressure on nearly all aspects of the U.S. health care system. Diabetes care is an example of the confluence of the pandemic and heightened importance of technology in changing care delivery. It has been estimated the added total direct U.S. medical cost burden due to COVID-19 to range between $160B (20% of the population infected) and $650B (80% of the population infected) over the course of the pandemic. The corresponding range for the population with diabetes is between $16B and $65B, representing between 5% and 20% of overall diabetes expenditure in the United States. We examine the evidence to support allocating part of this added spend to infrastructure capabilities to accelerate remote monitoring and management of diabetes. We reviewed recent topical literature and COVID-19-related analyses in the public health, health technology, and health economics fields in addition to databases and surveys from government sources and the private sector. We summarized findings on use cases for real-time continuous glucose monitoring in the community, for telehealth, and in the hospital setting to highlight the successes and challenges of accelerating the adoption of a digital technology out of necessity during the pandemic and beyond. One critical and lasting consequence of the pandemic will be the accelerated adoption of digital technology in health care delivery. We conclude by discussing ways in which the changes wrought by COVID-19 from a health care, policy, and economics perspective can add value and are likely to endure postpandemic.

摘要

2019 年冠状病毒病(COVID-19)大流行暴露了美国医疗体系几乎所有方面的脆弱性,并给其带来了巨大的财务压力。糖尿病管理就是大流行和技术在改变医疗服务提供方面的重要性日益增加的一个例子。据估计,由于 COVID-19,美国新增的直接医疗费用负担总额在 1600 亿美元(感染人口的 20%)至 6500 亿美元(感染人口的 80%)之间。糖尿病患者的相应范围在 160 亿美元至 650 亿美元之间,占美国糖尿病总支出的 5%至 20%。我们研究了支持将部分额外支出用于基础设施能力以加速糖尿病远程监测和管理的证据。我们审查了公共卫生、卫生技术和卫生经济学领域的近期专题文献以及与 COVID-19 相关的分析,此外还审查了政府来源和私营部门的数据库和调查。我们总结了实时连续血糖监测在社区、远程医疗和医院环境中的使用案例,以突出在大流行期间和之后出于必要性加速采用数字技术的成功和挑战。大流行的一个关键且持久的后果将是数字技术在医疗服务提供中的加速采用。最后,我们讨论了 COVID-19 从医疗保健、政策和经济学角度带来的变化如何增加价值并可能在大流行后持续存在。

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