Department of Economics, Center for Development and Regional Planning (CEDEPLAR), Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Pampulha, CEP 31.270-901 Belo Horizonte, Brazil.
Department of Economics, Center for Development and Regional Planning (CEDEPLAR), Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Pampulha, CEP 31.270-901 Belo Horizonte, Brazil.
Prim Care Diabetes. 2023 Oct;17(5):447-453. doi: 10.1016/j.pcd.2023.07.007. Epub 2023 Aug 3.
To evaluate the results of a program that offered access to HbA1c POC tests for the glycemic control of patients with diabetes in small and poor municipalities of Minas Gerais, Brazil.
Using a before and after study, we compared four groups: patients submitted to (i) POC tests; (ii) conventional tests; (iii) both tests; and (iv) neither test. The analysis considered three periods: before the program; before the pandemic; and during the pandemic. A cost comparison was conducted under the societal perspective and a cost-parity model was designed.
1349 patients previously diagnosed with diabetes were included in the analysis. The rate of consultations and the rate of HbA1c testing were significantly different between all periods and groups. Group iii had a much higher consultation and testing rate. The costs were around 89.45 PPP-USD for POC tests and between 32.44 and 54.66 PPP-USD for conventional tests. Cost-parity analysis suggests that the technology would be acceptable if the annual number of tests was between 247 and 771.
Using POC devices improved access to HbA1c testing but not glycemic control. Even in small towns, the number of tests necessary to achieve cost-parity is low enough to enable their incorporation into the public health system.
评估在巴西米纳斯吉拉斯州的小型贫困城市为糖尿病患者提供糖化血红蛋白即时检测（POC）以控制血糖的项目结果。
采用前后对照研究，我们比较了四个组：（i）接受 POC 检测的患者；（ii）接受常规检测的患者；（iii）接受两种检测的患者；以及（iv）未接受任何检测的患者。分析考虑了三个时期：项目前；大流行前；大流行期间。基于社会视角进行了成本比较，并设计了成本均等模型。
共纳入了 1349 名先前被诊断患有糖尿病的患者。所有时期和组间的就诊率和糖化血红蛋白检测率均有显著差异。组 iii 的就诊和检测率更高。POC 检测的成本约为 89.45 个购买力平价美元，常规检测的成本在 32.44 至 54.66 个购买力平价美元之间。成本均等分析表明，如果每年的检测次数在 247 至 771 次之间，该技术将具有可接受性。
使用 POC 设备可提高糖化血红蛋白检测的可及性，但无法改善血糖控制。即使在小城镇，实现成本均等所需的检测次数也足够低，足以将其纳入公共卫生系统。
