The Health Economic Evaluation Of "Three-manager Mode" Management For Hypertension In Xiamen

ObjectiveWith the increase of the annual incidence and mortality of hypertension in China,it is extremely urgent to increase the treatment rate and control rate of blood pressure.With the implementation of grading diagnosis and treatment,the importance and effectiveness of community chronic disease management are increasingly highlighted.Xiamen innovatively put forward the model of "Three-manager mode"based on community.This study intended to evaluate the short-term and long-term effects of this model in economics,and provided decision-making basis for the control of hypertension and the management of chronic diseases in the community of China.MethodsFive communities were randomly selected from 38 communities in Xiamen.586 people in the "Three-manager model" group and 621 in the conventional chronic disease management group.The "Three-manager mode" team was assigned to the net group.The conventional chronic disease management group was set to non-net group.A questionnaire survey was conducted from the aspects of patient demographic characteristics,disease cognition,self-management,and disease burden,and t-test,chi-square test,and rank-sum test were used to evaluate the effect of one-year access to the network,combining the project cost and disease burden to perform short-term incremental cost effectiveness/benefits analysis.At the same time,basing on the Health Big Data of Xiamen chronic disease management to build a decision tree-Markov model of hypertension,and the long-term effects of the simulation were evaluated by the incremental cost effectiveness analysis.ResultsEvaluation of "Three-manager mode" after one year,the increase of 1%self-management rate,disease awareness rate,blood pressure treatment rate and community transfer rate for the net group were 54.3,64.3,67.0 and 113.7 RMB respectively;The per capita net benefit of the "Three-manager mode" was 602 yuan,and the incremental benefit-cost ratio was 2.23:1.The decision tree-Markov model of hypertension simulates the state of 100,000 people in each state after 10 years.The simulation result shows that the per capita cost of the government is 77500 RMB for each case of reducing complications and the per capita cost of the government is 58600 RMB for each case of reducing death in the net group.According to the World Health Organization's economic evaluation criteria,all have economic benefits.ConclusionFrom the effect of short-term for joining net,the "Three-manager mode " project had improved the level of self-management and disease awareness and changed the bad lifestyle effectively.Long-term intervention had reduced the occurrence of complications and death.It reflected that the "Three-manager mode" model had good economic benefits in terms of incremental cost effectiveness/benefit,and can provide reference for the management of hypertension.