Gong Enying, Yang Bolu, Chen Xingxing, Li Yuhan, Li Zixiao, Bettger Janet Prvu, Oldenburg Brian, Dong Dejin, Si Lei, Yan Lijing L
School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Global Health Research Center, Duke Kunshan University, Kunshan, China.
Front Neurol. 2023 May 2;14:1145562. doi: 10.3389/fneur.2023.1145562. eCollection 2023.
Secondary prevention of stroke is a leading challenge globally and only a few strategies have been tested to be effective in supporting stroke survivors. The system-integrated and technology-enabled model of care (SINEMA) intervention, a primary care-based and technology-enabled model of care, has been proven effective in strengthening the secondary prevention of stroke in rural China. The aim of this protocol is to outline the methods for the cost-effectiveness evaluation of the SINEMA intervention to better understand its potential economic benefits.
The economic evaluation will be a nested study based on the SINEMA trial; a cluster-randomized controlled trial implemented in 50 villages in rural China. The effectiveness of the intervention will be estimated using quality-adjusted life years for the cost-utility analysis and reduction in systolic blood pressure for the cost-effectiveness analysis. Health resource and service use and program costs will be identified, measured, and valued at the individual level based on medication use, hospital visits, and inpatients' records. The economic evaluation will be conducted from the perspective of the healthcare system.
The economic evaluation will be used to establish the value of the SINEMA intervention in the Chinese rural setting, which has great potential to be adapted and implemented in other resource-limited settings.
中风的二级预防是全球面临的一项主要挑战，仅有少数策略经测试被证明对支持中风幸存者有效。系统整合与技术赋能的照护模式（SINEMA）干预是一种基于初级保健且技术赋能的照护模式，已被证明在中国农村地区加强中风二级预防方面有效。本方案的目的是概述SINEMA干预成本效益评估的方法，以更好地了解其潜在的经济效益。
经济评估将是一项基于SINEMA试验的嵌套研究；在中国农村50个村庄开展的一项整群随机对照试验。干预效果将通过用于成本效用分析的质量调整生命年以及用于成本效益分析的收缩压降低情况来评估。将根据药物使用、医院就诊和住院患者记录，在个体层面确定、测量并评估卫生资源和服务利用情况及项目成本。经济评估将从医疗保健系统的角度进行。
经济评估将用于确定SINEMA干预在中国农村环境中的价值，该模式在其他资源有限的环境中具有很大的适应和实施潜力。
