Evaluation of the effectiveness and cost-effectiveness of the chronic disease co-care (CDCC) Pilot Scheme: a study protocol.

IF 2 Q2 MEDICINE, GENERAL & INTERNAL
Ivy L Mak, Kiki S N Liu, Zoey C T Wong, Vivian Y H Xu, Esther Y T Yu, Tony K H Ha, William C W Wong, Emily T Y Tse, Linda Chan, Amy P P Ng, Edmond P H Choi, Martin Roland, David Bishai, Cindy L K Lam, Eric Y F Wan
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Abstract

Background: 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.

Methods: 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.

Discussion: 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.

Trial registration: NCT06310148; 2024-03-22.

慢性疾病共同护理(CDCC)试点计划的有效性和成本效益评估:一项研究方案。
背景:慢性疾病共同护理(CDCC)试点计划是一项政府补贴计划,旨在为私营医疗保健部门的高血压、糖尿病和前驱糖尿病的筛查和管理提供有针对性的共同支付。研究发现,由于降低了过早死亡率、并发症和公共卫生服务的利用率,同时进行多学科干预的筛查和管理可以节省成本。本研究旨在评估“疾控中心先导计划”的护理质素、可接受性、成效及成本效益。方法:护理质量将通过该计划在结构,过程和护理结果领域的每个标准中达到的标准进行评估。将在6个月和12个月时进行现场访问和两次系列问卷调查,以了解护理结构。将提取业务数据,包括提供诊断和治疗以及参与者的健康状况,以评估护理的过程和结果。通过电话调查对548名CDCC参与者进行3个月和12个月的体验(可及性、设施、护理和沟通的连续性)、满意度(感知有用性、延续性和推荐性)和实施情况的可接受性评估。有效性和成本效益评估是一项为期1年的比较队列研究,使用基线和12个月时CDCC和非CDCC参与者之间疾病控制参数变化的纵向数据。将评估服务提供者就计划的设立和运作成本,以及参与者在参加计划后12个月内使用公营和私营服务而产生的直接医疗费用的成本调查表。12个月后,每增加一名疾控中心试验计划参与者为达到目标疾病控制结果而产生的增量成本,将作为成本效益指标予以报告。讨论:本研究将会检视“疾控中心试验计划”在改善计划参与者健康结果方面的护理质素和成效。制定良好做法的标准和提高服务质量的建议,为类似跨行业筛选和管理计划的服务规划提供参考。试验注册:NCT06310148;2024-03-22。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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