Journal of Education and Health Promotion

Abstract BACKGROUND: The long‑term outcomes are important concepts for cost‑effectiveness analysis
in patients with premature coronary artery disease after revascularization (coronary artery bypass
grafting [CABG] and percutaneous coronary intervention [PCI]) and medical therapy (MT). The
finding of this study will be used to calculate the events probabilities for cost‑effectiveness study.
METHODS AND ANALYSIS: This systematic review will use studies in which patients age must be
18–60 years in eligible studies that obtained from PubMed, Web of Science, Scopus, and Embase.
We will assess the long‑term outcomes after CABG, PCI, and MT by random‑effects meta‑analysis
and effects will be shown by risk ratio. We will ascertain the probabilities of adverse events during
certain periods and then outcomes will compare separately based on specific characteristics.
CONCLUSION: This study will provide information related to outcomes of CABG, PCI, and MT
in patients with premature coronary artery disease. Doing this systematic review is valuable from
clinically and economically aspects such as cost‑effectiveness and cost‑utility analysis.

Abstract Population aging has increased the need for long‑term care of older persons who suffer from
multi‑morbidity and chronic conditions. Today, the majority of older people are living alone in their
home in which they try to cope with highly risky conditions such as sensory impairment, diminished
mobility, and medication management. Recent developments in information technologies could
improve the access to care for older people as well as reducing the need for full‑time caregivers
both in homes and institutions such as nursery homes and hospitals. This study aimed to review
the economic evaluation of such technological advancements in the care of older people. Through
a systematic approach, electronic databases were searched and of 2732 records retrieved, three
papers were included in the final review. Three different models of economic evaluation including
cost analysis, cost–benefit analysis and cost‑effectiveness analysis were applied in these studies
in the context of telemedicine and older persons’ care. Since the methodological approaches were
quite different and the outcomes reported were not consistent between studies, no meta‑analysis
was applicable and we qualitatively reviewed the papers. All studies have reported cost savings
associated with the use of telemedicine technologies such as video visits and smart homes in the
care of older persons.

Abstract BACKGROUND: The purpose of this study was to evaluate diabetes control, as measured by
hemoglobin A1c (HbA1c) improvements among African American and Hispanic patients receiving
conventional clinical treatment combined with a bilingual diabetes educator using culturally and
linguistically appropriate educational materials. This study also sought to estimate the healthcare cost
savings resulting from any A1c improvements and assess the cost‑effectiveness of this approach.
MATERIALS AND METHODS: This was a multistage, face‑to‑face observational study undertaken
in Texas, United States and focused on 153 African American and Hispanic patients with poor
blood glucose control (baseline A1c >8.0%). For two years, a bilingual care coordinator motivated
patient behavior changes that could lead to improvements in glucose control. The primary
evaluation measure was change in %HbA1c, with secondary measures being change in blood
pressure (BP) and low‑density lipoprotein (LDL). We also sought to gauge the program’s potential
cost‑effectiveness.
RESULTS: Within the study group, A1c levels decreased over the study period from a mean of
10.0% to 8.4%. The same group saw no statistically significant improvement (reduction) in blood
concentrations of LDL. The African American subgroup had a small reduction in systolic BP while
changes for non‑White Hispanics were not statistically significant. The average A1c reduction
realized in this observational study provided estimated cost savings that are nearly twice pilot
expenditures.
CONCLUSIONS: Combining standard diabetes care with a bilingual educational care coordinator
results in significant reductions in mean A1c (−1.6% HbA1c) in patients with poorly controlled blood
glucose and African American/non‑White Hispanic heritage, an intervention that also was shown to
be cost‑effective. This may be an effective model for improving diabetes care in provider practices.