Costs and Cost-Effectiveness of mCME Version 2.0: An SMS-Based Continuing Medical Education Program for HIV Clinicians in Vietnam.
Costs and Cost-Effectiveness of mCME Version 2.0: An SMS-Based Continuing Medical Education Program for HIV Clinicians in Vietnam.
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DOI：
10.9745/ghsp-d-22-00008
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发表时间：
2022-08-30
期刊：
影响因子：
--
通讯作者：
Gill CJ
中科院分区：
文献类型：
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作者：
Sabin LL;Mesic A;Le BN;Halim N;Cao CTH;Bonawitz R;Nguyen HV;Larson A;Nguyen TTT;Le AN;Gill CJ
这项成本分析发现，北方越南艾滋病毒临床医生基于移动的电话的继续医学教育（mCME）干预措施，包括每天发送带有相关材料链接的短信，成本相对较低，具有成本效益，特别是对于未来的全国模式。在资源受限的环境中，这种移动的继续医学教育方法值得关注。这项研究发现，一个非常成功的电话为基础的继续医学教育（CME）干预艾滋病毒临床医生在越南北方是成本相对较低，成本效益相比。从成本的角度来看，将固定成本分摊到该计划的全国范围内的预测未来模式更具吸引力。这些研究结果表明，移动的方法来继续医学教育可以是相当具有成本效益的，是值得关注的资源有限的设置。政策制定者和国家利益相关者应考虑替代传统的面对面继续医学教育，包括方便参与者、有效且实施成本相对较低的移动的方法（基于短信）。资源受限环境中的政策制定者应考虑长期和广泛地投资于创新和具有成本效益的移动的基于电话的继续医学教育，因为此类策略可能具有相当大的设置成本，但可以激励临床医生改善自学习惯并以关键方式增加知识。移动的继续医学教育（mCME）2.0项目是一项随机对照试验，该试验发现，为期6个月的基于短信的继续医学教育干预改善了越南艾滋病毒临床医生干部对在线医学培训资源的使用和医学知识。这项伴随研究分析了干预成本和成本效益。我们进行了（1）基于试验规划和实施期间产生的成本的财务分析;（2）考虑资源利用的经济分析;以及（3）成本效益分析，以估计与影响相关的成本投入：自学增加（通过访问在线课程来衡量）和知识增加（通过考试成绩提高来衡量）（以2016年美元计）。最后，我们估计了一个9个月的国家计划和一个10年的扩大模型的经济成本（以2021年美元计）。干预的总财务成本为49，552美元;主要成本驱动因素是人员时间（71.4%）和技术投入（14.9%）。总经济成本估计为92，212美元，主要成本投入相同（分别占总成本的77. 7%及8. 0%）。访问在线课程每增加10%的财务成本为923美元，而提高知识的成本（通过研究人群平均考试成绩提高10%来衡量）为32，057美元（每位干预临床医生605美元）。每项改善的可比总经济成本分别为1，770美元和61，452美元（每名干预医生1，159美元）。未来9个月的国家方案估计耗资37，403美元，而整个10年扩大方案估计耗资196，446美元。这一分析表明，利用移动的技术可能是一种可行的方式，以相对较低的成本提供远程学习，越南各地的卫生专业。考虑到在世界资源有限地区扩大继续医学教育的实际方法的需要，这种方法值得进一步研究和可能的采用。
This cost analysis found that a mobile phone-based continuing medical education (mCME) intervention, involving daily text messages with links to relevant materials, for HIV clinicians in northern Vietnam was relatively low-cost and cost-effective, particularly for future nationwide models. Such mobile approaches to CME are worthy of attention in resource-constrained settings. This study found that a highly successful phone-based continuing medical education (CME) intervention for HIV clinicians in northern Vietnam was relatively low-cost and cost-effective when costs were compared to benefits. Forecasted future models that spread fixed costs over expanded nationwide versions of the program are even more appealing from a cost perspective. These findings suggest that mobile approaches to CME can be quite cost-effective and are worthy of attention in resource-constrained settings. Policy makers and national stakeholders should consider alternatives to traditional in-person CME, including mobile approaches (based on text messages) that are convenient for participants, effective, and relatively low cost to implement. Policy makers in resource-constrained environments should consider investing in innovative and cost-effective mobile phone-based CME on a long-term and widespread basis given that such strategies may have considerable set-up costs but can motivate clinicians to improve self-study habits and increase knowledge in critical ways. The Mobile Continuing Medical Education (mCME) 2.0 project was a randomized controlled trial that found that a 6-month text message-based CME intervention improved both the use of online medical training resources and medical knowledge among a cadre of HIV clinicians in Vietnam. This companion study analyzed intervention costs and cost-effectiveness. We conducted (1) a financial analysis based on costs incurred during the trial’s planning and implementation; (2) an economic analysis to consider resource utilization; and (3) cost-effectiveness analyses to estimate cost inputs relative to impact: increase in self-study (measured by visits to online courses) and increase in knowledge (measured by exam score improvement) (in 2016 US$). Finally, we estimated the economic cost of a 9-month national program and a 10-year scaled-up model (in 2021 US$). The total financial cost of the intervention was US$49,552; the main cost drivers were personnel time (71.4%) and technology inputs (14.9%). The total economic cost was estimated at US$92,212, with the same key cost inputs (representing 77.7% and 8.0%, respectively, of total costs). The financial cost per 10% increase in accessing online courses was US$923, while the cost of improving knowledge, measured by a 10% improvement in mean exam score across the study population, was US$32,057 (US$605 per intervention clinician). The comparable total economic cost of each improvement, respectively, was US$1,770 and US$61,452 (US$1,159 per intervention clinician). A future 9-month national program was estimated to cost US$37,403, while the full 10-year scaled-up program was estimated at US$196,446. This analysis indicates that leveraging mobile technology could be a feasible way to provide distance learning to health professions across Vietnam at a relatively low cost. Given the need for practical ways to expand CME in resource-constrained regions of the world, this approach warrants further study and possible adoption.
DOI：
10.1016/j.jctube.2021.100238
发表时间：
2021-05
影响因子：
2
作者：
Koshy M;Mische L;Rizza S;Mahmood M;Bedimo R;Bhatia R;El Atrouni W;Curran J;Temesgen Z
通讯作者：
Temesgen Z