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KMID : 1146320210090010049
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Journal of Health Technology Assessment
2021 Volume.9 No. 1 p.49 ~ p.57
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Systematic Review of Economic Evaluation Model of Information and Communication Technologies Based Monitoring in Chronic Disease Management: Hypertension and Diabetes Mellitus
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Oh Sung-Hee
Kwon Jin-Won
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Abstract
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Objectives: Chronic diseases are associated with increased cardiovascular disease (CVD) and mortality, causing premature death and undermining individual quality of life, which has a huge economic impact on society. As new interventions become available, estimates of economic and clinical outcome based on decision-analytic models are required. We aimed to systematically review economic models of information and communication technologies (ICT) based Monitoring in Chronic Disease Management.
Methods: The search for potentially relevant studies was conducted on using PubMed, Cochrane Library, and two Korean databases up to October 2020. Data related to model structure and assumptions, effect estimation and cost estimation were extracted from each model. Data synthesis of the included studies was performed using a qualitative method.
Results: Selected models were classified into hypertension models (n=2) and diabetes models (n=5). Typically, the published models utilized frameworks based on systolic blood pressure or HbA1c. Under the assumption that short-term effects of intervention will last for a long time, core structures are Markov models that estimates long-term effects based on the patient’s baseline risk factors observed in clinical trials, using CVD risk assessment tools such as the Framingham prediction model. From the perspective of the healthcare system, the cost items expend during a time horizon of lifetime included Physician visit, Drug, intervention (consisting of equipment, running, training and coordinator costs) and treatment costs of complications.
Conclusion: This study confirmed the conceptualization and structuring process of the economic model of ICT-based monitoring services for patients with chronic disease. Clarifying this process, and evaluating structural uncertainty will improve the quality of the model and increase the reliability of predicting outcomes. We suggest to design models through the published literature review to increase model validity, which is expected to help provide reliable information to decision makers by enhancing transparency, comprehensiveness and consistency of model structuring.
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KEYWORD
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Systematic review, Chronic disease, Information and Communication Technologies based Monitoring, Telemedicine, Economic evaluation model, Model structure
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