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The evaluation of alternative care pathways for the management of non-communicable diseases at tertiary care hospital during the situation of COVID-19 pandemic |
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| รหัสดีโอไอ | |
| Title | The evaluation of alternative care pathways for the management of non-communicable diseases at tertiary care hospital during the situation of COVID-19 pandemic |
| Creator | Jongkonnee Chongpornchai |
| Contributor | Tuangrat Phodha, Advisor |
| Publisher | Thammasat University |
| Publication Year | 2568 |
| Keyword | COVID-19, Care pathway, Telehealth, NCDs, Diabetes, Hypertension |
| Abstract | Background: The management of non-communicable diseases (NCDs), such as hypertension (HT) and diabetes mellitus (DM), were significantly impacted by the COVID-19 pandemic as many institutions adopted alternative care pathways, e.g., pharmacy at home (PAH), and the deferred care (DC) programs. While some studies have assessed the clinical outcomes of PAH program, there is a paucity of evaluative work dealing with the clinical and economic impacts of DC programs. Consequently, this study evaluates the clinical and economic outcomes of the adoption of PAH and DC programs as alternatives to usual care.Method: A retrospective study was conducted at a tertiary care hospital in Thailand concerning the management of HT and DM patients during July 2021 to December 2021 and following July 2022 to December 2022. Administrative and clinical data were drawn from outpatient encounters according to three management options: PAH; DC; or discharged home with follow-up at the hospital. Multivariate multilevel mixed-effects linear and log-linear regression methods were used to assess the impact of care pathways on clinical and economic outcomes, respectively.Results: There were 3,518 patients during the pandemic and 4,135 patients following the pandemic that were included in this study. There was no statistically significant impact of the PAH and DC on the changes of systolic blood pressure, diastolic blood pressure, and fasting blood sugar, but the PAH and DC did have a significant impact on the cost of illness in both periods significantly (p< 0.001).Conclusions: The used of PAH and DC programs reduced costs but did not worsen clinical outcomes for DM and HT patients during and following the pandemic. These programs are appropriate for regular use and may be further reactivated in the event of future emergencies. |
