Cost-Effectiveness of Mobile Health-Based Integrated Care for Atrial Fibrillation: Model Development and Data Analysis

作者全名："Luo, Xueyan; Xu, Wei; Ming, Wai-Kit; Jiang, Xinchan; Yuan, Quan; Lai, Han; Huang, Chunji; Zhong, Xiaoni"

作者地址："[Luo, Xueyan; Lai, Han; Zhong, Xiaoni] Chongqing Med Univ, Sch Publ Hlth & Management, 1 Yi Xue Lu, Chongqing 400016, Peoples R China; [Luo, Xueyan] Chongqing Univ Educ, Sch Biol & Chem Engn, Chongqing, Peoples R China; [Luo, Xueyan; Zhong, Xiaoni] Chongqing Med Univ, Res Ctr Med & Social Dev, Chongqing, Peoples R China; [Xu, Wei] China Pharmaceut Univ, Sch Int Pharmaceut Business, Nanjing, Peoples R China; [Ming, Wai-Kit] City Univ Hong Kong, Dept Infect Dis & Publ Hlth, Hong Kong, Peoples R China; [Jiang, Xinchan] Chinese Univ Hong Kong, Sch Pharm, Hong Kong, Peoples R China; [Yuan, Quan] Chong Qing Pharmaceut Grp Co Ltd, Chongqing, Peoples R China; [Huang, Chunji] Army Med Univ, Sch Basic Med Sci, Chongqing, Peoples R China"

通信作者："Zhong, XN (通讯作者)，Chongqing Med Univ, Sch Publ Hlth & Management, 1 Yi Xue Lu, Chongqing 400016, Peoples R China."

来源：JOURNAL OF MEDICAL INTERNET RESEARCH

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000800588700001

JCR分区：Q1

影响因子：7.4

年份：2022

卷号：24

期号：4

开始页：　

结束页：　

文献类型：Article

关键词：mobile health; integrated care; ABC pathway; atrial fibrillation; model-based; cost-effectiveness; health economic evaluation

摘要："Background: Mobile health (mHealth) technology is increasingly used in disease management. Using mHealth tools to integrate and streamline care has improved clinical outcomes of patients with atrial fibrillation (AF). Objective: The aim of this study was to investigate the potential clinical and health economic outcomes of mHealth-based integrated care for AF from the perspective of a public health care provider in China. Methods: A Markov model was designed to compare outcomes of mHealth-based care and usual care in a hypothetical cohort of patients with AF in China. The time horizon was 30 years with monthly cycles. Model outcomes measured were direct medical cost, quality-adjusted life years (QALYs), and incremental cost-effectiveness ratio (ICER). Sensitivity analyses were performed to examine the robustness of the base-case results. Results: In the base-case analysis, mHealth-based care gained higher QALYs of 0.0730 with an incurred cost of US $1090. Using US $33,438 per QALY (three times the gross domestic product) as the willingness-to-pay threshold, mHealth-based care was cost-effective, with an ICER of US $14,936 per QALY. In one-way sensitivity analysis, no influential factor with a threshold value was identified. In probabilistic sensitivity analysis, mHealth-based care was accepted as cost-effective in 92.33% of 10,000 iterations. Conclusions: This study assessed the expected cost-effectiveness of applying mHealth-based integrated care for AF according to a model-based health economic evaluation. The exploration suggested the potential cost-effective use of mHealth apps in streamlining and integrating care via the Atrial fibrillation Better Care (ABC) pathway for AF in China. Future economic evaluation alongside randomized clinical trials is highly warranted to verify the suggestion and investigate affecting factors such as geographical variations in patient characteristics, identification of subgroups, and constraints on local implementation."

基金机构：National Natural Science Foundation of China [72074220]; Humanities and Social Science Research Program of Chongqing Municipal Education Commission [21SKGH283]; Scientific and Technological Research Program of Chongqing Municipal Education Commission [KJ1901535]; Research Program of Innovative Research Demonstration Base of Children's Medical Security [NCRCCHD-2019-HP-12]

基金资助正文："We acknowledge the financial support received from the National Natural Science Foundation of China (72074220) , Humanities and Social Science Research Program of Chongqing Municipal Education Commission (21SKGH283) , Research Program of Innovative Research Demonstration Base of Children's Medical Security (NCRCCHD-2019-HP-12) , and Scientific and Technological Research Program of Chongqing Municipal Education Commission (KJ1901535) ."