Evidence mapPaperPMID 39156174Full record

ArticleKidney international reports2024

Economic Evaluation of an Integrated Care Program Compared to Conventional Care for Patients With Chronic Kidney Disease in Rural Communities of Thailand.

Molly Paffett, Jeerath Phannajit, Kinanti Khansa Chavarina, Tanainan Chuanchaiyakul, Teerayuth Jiamjariyapon, Teerawat Thanachayanont, Methee Chanpitakkul, Salyaveth Lekagul, Yot Teerawattananon, Kriang Tungsanga

Abstract read
In one paragraph

Article in Kidney international reports, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Article
  5. The catastrophic costs of chronic kidney disease.Nature reviews. Nephrology · 2025
    Article
  6. Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Molly PaffettHealth Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand.
Jeerath PhannajitDivsion of Clinical Epidemiology, Department of Medicine, King Chulalongkorn Memorial Hospital and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Kinanti Khansa ChavarinaHealth Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand.
Tanainan ChuanchaiyakulHealth Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand.
Teerayuth JiamjariyaponBhumirajanagarindra Kidney Institute Hospital, Bangkok, Thailand.
Teerawat ThanachayanontBhumirajanagarindra Kidney Institute Hospital, Bangkok, Thailand.
Methee ChanpitakkulBhumirajanagarindra Kidney Institute Hospital, Bangkok, Thailand.
Salyaveth LekagulBhumirajanagarindra Kidney Institute Hospital, Bangkok, Thailand.
Yot TeerawattananonHealth Intervention and Technology Assessment Program (HITAP), Ministry of Public Health, Nonthaburi, Thailand.
Kriang TungsangaDivsion of Nephrology, Department of Medicine, King Chulalongkorn Memorial Hospital and Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction: An integrated care program for chronic kidney disease (CKD) in Thailand has shown its effectiveness in delaying the decline in kidney function, as evidenced by the Effectiveness of Integrated Care on Delaying Progression of Stages 3 to 4 CKD in Rural Communities of Thailand (ESCORT-1) randomized control trial and the ESCORT-2 prospective cohort study. Designed for sustainability within the primary healthcare system, the program optimizes the use of the existing workforce by fostering collaboration among local multidisciplinary care teams (MDCTs) and community care networks (CCNs). Methods: A Markov model with a lifetime horizon was used to conduct a cost-utility analysis from a societal perspective. Individual participant level data from ESCORT studies, national registries, and relevant literature were used to estimate model parameters. A budget impact analysis from the payer's perspective was also assessed over a 5-year period. Results: The integrated care program yielded a dominant result with 1.84 quality-adjusted life years (QALYs) gained with "less" lifetime cost, resulting in a negative incremental cost-effectiveness ratio (ICER). Probabilistic analysis showed that the intervention being cost-effective almost 100% of the time at the local willingness-to-pay threshold. The intervention maximized cost-effectiveness when delivered as early as possible, both in terms of age and stage. The budget impact analysis estimated that the introduction of the intervention could save about 7% of the Thai government's total health expenditure or 205 billion Thai-Baht ($5.9 billion) over 5 years with cost savings beginning from the third year onwards. Conclusion: The integrated care program for CKD offers potential benefits and cost savings for patients, caregivers, and payers. Future efforts should focus on the screening and implementation processes across various regions and healthcare settings.

Indexed as

budget impactchronic kidney diseasecommunity care networkintegrated carelower-middle-income countrymultidisciplinary care team

Identifiers

PMID39156174
PMCPMC11328750

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.