Mak Ivy L, Liu Kiki S N, Wong Zoey C T, Xu Vivian Y H, Yu Esther Y T, Ha Tony K H, Wong William C W, Tse Emily T Y, Chan Linda, Ng Amy P P, Choi Edmond P H, Roland Martin, Bishai David, Lam Cindy L K, Wan Eric Y F
Department of Family Medicine and Primary Care, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
Primary Healthcare Commission, Health Bureau, Hong Kong, China.
BMC Prim Care. 2025 Mar 19;26(1):73. doi: 10.1186/s12875-025-02765-6.
The Chronic Disease Co-Care (CDCC) Pilot Scheme is a government-subsidized program that aims to provide targeted copayment for the screening and management of hypertension, diabetes mellitus and pre-diabetes in the private healthcare sector. Studies have found that concurrent screening and management with a multi-disciplinary intervention is cost-saving because of the reduction in the rates of premature mortality, complications and utilization of public health services. This study aims to evaluate the quality of care, acceptability, effectiveness and cost-effectiveness of the CDCC Pilot Scheme.
Quality of care will be evaluated by the standards achieved by the program in each criterion in the domains of structure, process and outcomes of care. Site visits and two serial questionnaire surveys at 6 and 12 months will be conducted for the structure of care. Operational data, including the provision of diagnosis and treatment, as well as participants' health status will be extracted to evaluate the process and outcomes of care. Participants' acceptability will be evaluated on experience (accessibility, facility, continuity of care and communication), satisfaction (perceived usefulness, continuation and recommendation) and enablement in 548 CDCC participants at 3 and 12 months by telephone surveys. Evaluation of the effectiveness and cost-effectiveness is a 1-year comparative cohort study using longitudinal data on changes in disease control parameters between CDCC and non-CDCC participants at baseline and 12 months. Costing questionnaires on the set-up and operation costs of the Scheme among service providers, and direct medical costs incurred from public and private service utilization among participants within 12 months from enrolment will be assessed. The incremental costs incurred for an additional participant in the CDCC Pilot Scheme to achieve target disease control outcomes after 12 months will be reported as an indicator for cost-effectiveness.
The quality of care and effectiveness of the CDCC Pilot Scheme in enhancing the health outcomes of the Scheme participants will be examined. Standards of good practice and recommendations for quality enhancement will be established to inform service planning in similar cross-sector screening and management programme.
NCT06310148; 2024-03-22.
慢性病共同照护（CDCC）试点计划是一项政府补贴项目，旨在为私营医疗保健部门的高血压、糖尿病和糖尿病前期的筛查及管理提供有针对性的自付费用。研究发现，通过多学科干预进行同步筛查和管理可节省成本，原因是过早死亡率、并发症发生率以及公共卫生服务利用率有所降低。本研究旨在评估CDCC试点计划的护理质量、可接受性、有效性和成本效益。
护理质量将根据该计划在护理结构、过程和结果等领域各标准中所达到的水平进行评估。将针对护理结构进行实地考察，并在6个月和12个月时进行两次连续问卷调查。将提取包括诊断和治疗提供情况以及参与者健康状况在内的运营数据，以评估护理过程和结果。将通过电话调查在3个月和12个月时对548名CDCC参与者的经验（可及性、设施、护理连续性和沟通）、满意度（感知有用性、继续参与和推荐）以及赋能情况进行评估，以此评价参与者的可接受性。有效性和成本效益评估是一项为期1年的比较队列研究，使用基线时和12个月时CDCC参与者与非CDCC参与者之间疾病控制参数变化的纵向数据。将评估服务提供者关于该计划设立和运营成本的成本核算问卷，以及参与者在入组后12个月内使用公共和私人服务产生的直接医疗成本。将报告CDCC试点计划中额外一名参与者在12个月后实现目标疾病控制结果所产生 的增量成本，作为成本效益指标。
将研究CDCC试点计划在改善计划参与者健康结果方面的护理质量和有效性。将制定良好实践标准和质量提升建议，为类似跨部门筛查和管理计划的服务规划提供参考。
NCT06310148；2024年3月22日。
