Economic analysis of the diabetes and hypertension screening collaboration between community pharmacies and a Thai government primary care unit

Prim Care Diabetes. 2010 Oct;4(3):155-64. doi: 10.1016/j.pcd.2010.05.003. Epub 2010 Jun 16.

Abstract

Aims: To evaluate models for collaboration between community pharmacies and a government primary care unit (PCU) in carrying out a screening program for diabetes and hypertension.

Methods: An action research was undertaken and a screening and referring protocol developed. Study sites were two community pharmacies (Model 1) and footpaths/streets and seven communities (Model 2) under supervision of PCU in the city of Maha Sarakham Province, Thailand. The Combined Model consisted of Models 1 and 2. Those eligible were aged 40 years and over, not known to have diabetes or hypertension. Activity based costing of three models was analyzed from the provider perspective.

Results: The study involved 456 people during July-September 2007; 11 out of 51 attending pharmacies (21.6%) and 27 out of 405 attending the communities (6.6%) met criteria for referral to PCU for confirmatory diagnosis. Only six attended the PCU. Two of 456 (0.4%) were confirmed the diagnosis having hypertension, one was referred from a pharmacy (2%, 1/51) the other from a community (0.2%, 1/405). Model unit costs were US$ 11.2, 4.3 and 5.1 per screened person, respectively.

Conclusions: The results indicate a working model can identify people in the community requiring treatment of hypertension or diabetes. Pharmacy-based screening was more costly, but the success rate for referral was higher compared with a community-based service. More effort is needed to ensure referred patients attend the PCU.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Community Pharmacy Services / economics*
  • Cooperative Behavior*
  • Cost-Benefit Analysis
  • Diabetes Mellitus / diagnosis*
  • Diabetes Mellitus / economics
  • Female
  • Government Programs / economics*
  • Health Care Costs
  • Humans
  • Hypertension / diagnosis*
  • Hypertension / economics
  • Interinstitutional Relations*
  • Male
  • Mass Screening / economics*
  • Middle Aged
  • Models, Economic
  • Patient Acceptance of Health Care
  • Primary Health Care / economics*
  • Program Evaluation
  • Referral and Consultation / economics
  • Thailand