Economic analysis of the diabetes and hypertension screening collaboration between community pharmacies and a Thai government primary care unit.
OBJECTIVE
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.
Sookaneknun
Phayom
P
Primary Care Practice Research Unit, Faculty of Pharmacy, Mahasarakham University, Maha Sarakham Province 44150, Thailand. psookane@yahoo.com
Saramunee
Kritsanee
K
Rattarom
Ruchilak
R
Kongsri
Suratchada
S
Senanok
Ratana
R
Pinitkit
Pongpan
P
Sawangsri
Wathana
W
Deesin
Bhudtharat
B
D000328:Adult; D000368:Aged; D003157:Community Pharmacy Services / Q000191:economics*; D003299:Cooperative Behavior; D003362:Cost-Benefit Analysis; D003920:Diabetes Mellitus / Q000175:diagnosis* / Q000191:economics; D005260:Female; D006078:Government Programs / Q000191:economics*; D017048:Health Care Costs; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000191:economics; D007373:Interinstitutional Relations; D008297:Male; D008403:Mass Screening / Q000191:economics*; D008875:Middle Aged; D018803:Models, Economic; D010342:Patient Acceptance of Health Care; D011320:Primary Health Care / Q000191:economics*; D015397:Program Evaluation; D012017:Referral and Consultation / Q000191:economics; D013785:Thailand