Division of Cancer Control and Policy, National Cancer Control Institute, National Cancer Center, 323, Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 10408, Republic of Korea.
Research and Analysis Team, National Health Insurance Service, Ilsan Hospital, 100 Ilsan-ro, Ilsan-donggu, Goyang-si, Gyeonggi-do 10444, Republic of Korea.
Int J Qual Health Care. 2021 Apr 30;33(2). doi: 10.1093/intqhc/mzab073.
The Chronic Disease Management Program (CDMP) of Korea has been introduced to improve care continuity in patients with hypertension and diabetes.
This study evaluated the cost effectiveness of the CDMP in patients with hypertension from the perspective of the healthcare payer.
A cost-effectiveness analysis was performed based on a Markov simulation model. The cost and effect of the CDMP versus usual care was compared in individuals aged 40 years or above. The two strategies were presumed to result in a difference in the incidence of myocardial infarction, stroke, and chronic kidney disease. The model was analyzed over the lifetime of the cohort. Incremental cost-effectiveness ratio (ICER) was calculated by dividing the difference in lifetime costs by the difference in lifetime effects (quality adjusted life years, QALYs) between the two strategies. Costs were expressed in Korean Won (KRW).
The ICER value of the CDMP participation strategy was -5 761 088 KRW/QALY compared to usual care. Similar tendencies were found when limiting the population to only clinic users (-3 843 355 KRW/QALY) and national health examination participants (-5 595 185 KRW/QALY).
The CDMP was highly cost-effective in patients with hypertension aged 40 years or above. Implementing efficient policies that enhance care coordination and improve outcomes in patients with hypertension is important.
韩国的慢性病管理计划（CDMP）旨在提高高血压和糖尿病患者的护理连续性。
本研究从医疗保健支付者的角度评估了 CDMP 在高血压患者中的成本效益。
基于马尔可夫模拟模型进行成本效益分析。将 CDMP 与常规护理在 40 岁及以上人群中的成本和效果进行比较。假定两种策略会导致心肌梗死、中风和慢性肾脏病的发病率有所不同。该模型对队列的整个生命周期进行了分析。通过将两种策略之间的终生成本差异除以终生效果（质量调整生命年，QALY）差异来计算增量成本效益比（ICER）。成本以韩元（KRW）表示。
与常规护理相比，CDMP 参与策略的 ICER 值为-5761088 韩元/QALY。当将人群仅限于诊所使用者（-3843355 韩元/QALY）和国家健康检查参与者（-5595185 韩元/QALY）时，也发现了类似的趋势。
对于 40 岁及以上的高血压患者，CDMP 具有很高的成本效益。实施能够增强高血压患者护理协调性并改善其治疗效果的高效政策非常重要。
