Ye Caihua, Zhou Qiwei, Yang Wenfei, Tao Libo, Jiang Xinjun
International Nursing School, Hainan Medical University, Haikou, Hainan, China.
Center for Health Policy and Technology Evaluation, Peking University Health Science Center, Beijing, China.
Front Public Health. 2024 Nov 21;12:1467178. doi: 10.3389/fpubh.2024.1467178. eCollection 2024.
Diabetes structured education programs have been demonstrated to effectively improve glycemic control and self-management behaviors. However, evidence on the health economic evaluation of these programs is limited.
To systematically review the health economic evaluation of structured education programs for patients with type 1 and type 2 diabetes mellitus.
The English databases PUBMED, WEB OF SCIENCE, OVID, COCHRANE LIBRARY, EMBASE, and EBSCO, along with the Chinese databases CNKI, WANFANG, VIP, and SINOMED, were searched from their inception to September 2024. The quality of the literature was assessed using the CHEERS 2022 checklist. A descriptive analysis was performed on the studies included in the review, with all currencies converted to international dollars. An incremental cost-effectiveness ratio of less than one times the GDP was considered highly cost-effective, while a ratio between one and three times the GDP was considered cost-effective.
A total of 28 studies from upper-middle-income and high-income countries were included. The average quality score of the included studies was 18.6, indicating a moderate level of reporting quality. Among these, eleven studies demonstrated that diabetes structured education programs were highly cost-effective and twelve were found to be cost-effective. In contrast, three studies were deemed not cost-effective, and two studies provided uncertain results. The ranges of the incremental cost-effectiveness ratios for short-term, medium-term, and long-term studies were - 520.60 to 65,167.00 dollars, -24,952.22 to 14,465.00 dollars, and -874.00 to 236,991.67 dollars, respectively.
This study confirms the cost-effectiveness of structured education programs for diabetes and highlights their importance for patients with type 2 diabetes who have HbA1c levels exceeding 7% and are receiving non-insulin therapy. Additionally, the potential advantages of incorporating telecommunication technologies into structured diabetes education were emphasized. These findings offer valuable insights and guidance for decision-making in diabetes management and clinical practice, contributing to the optimization of medical resource allocation and the improvement of health status and quality of life for patients.
糖尿病结构化教育项目已被证明能有效改善血糖控制和自我管理行为。然而，关于这些项目的卫生经济评估的证据有限。
系统评价1型和2型糖尿病患者结构化教育项目的卫生经济评估。
检索英文数据库PUBMED、科学网、OVID、考克兰图书馆、EMBASE和EBSCO，以及中文数据库中国知网、万方、维普和中国生物医学文献数据库，检索时间从建库至2024年9月。使用CHEERS 2022清单评估文献质量。对纳入综述的研究进行描述性分析，所有货币均换算为国际美元。增量成本效益比低于国内生产总值1倍被认为具有高成本效益，而在国内生产总值1至3倍之间的比率被认为具有成本效益。
共纳入来自中高收入国家和高收入国家的28项研究。纳入研究的平均质量评分为18.6，表明报告质量处于中等水平。其中，11项研究表明糖尿病结构化教育项目具有高成本效益，12项研究被发现具有成本效益。相比之下，3项研究被认为不具有成本效益，2项研究结果不确定。短期、中期和长期研究的增量成本效益比范围分别为−520.60至65167.00美元、−24952.22至14465.00美元和−874.00至236991.67美元。
本研究证实了糖尿病结构化教育项目的成本效益，并强调了其对糖化血红蛋白水平超过7%且正在接受非胰岛素治疗的2型糖尿病患者的重要性。此外，强调了将电信技术纳入结构化糖尿病教育中的潜在优势。这些发现为糖尿病管理决策和临床实践提供了有价值的见解和指导，有助于优化医疗资源配置，改善患者的健康状况和生活质量。
