Evaluation of the effectiveness and cost-effectiveness of the chronic disease co-care (CDCC) Pilot Scheme: a study protocol

Abstract

Background: The Chronic Disease Co-Care (CDCC) Pilot Scheme is a government-subsidized program that aims to provide targeted copayment for the screening and management of hypertension, diabetes mellitus and pre-diabetes in the private healthcare sector. Studies have found that concurrent screening and management with a multi-disciplinary intervention is cost-saving because of the reduction in the rates of premature mortality, complications and utilization of public health services. This study aims to evaluate the quality of care, acceptability, effectiveness and cost-effectiveness of the CDCC Pilot Scheme. Methods: Quality of care will be evaluated by the standards achieved by the program in each criterion in the domains of structure, process and outcomes of care. Site visits and two serial questionnaire surveys at 6 and 12 months will be conducted for the structure of care. Operational data, including the provision of diagnosis and treatment, as well as participants’ health status will be extracted to evaluate the process and outcomes of care. Participants’ acceptability will be evaluated on experience (accessibility, facility, continuity of care and communication), satisfaction (perceived usefulness, continuation and recommendation) and enablement in 548 CDCC participants at 3 and 12 months by telephone surveys. Evaluation of the effectiveness and cost-effectiveness is a 1-year comparative cohort study using longitudinal data on changes in disease control parameters between CDCC and non-CDCC participants at baseline and 12 months. Costing questionnaires on the set-up and operation costs of the Scheme among service providers, and direct medical costs incurred from public and private service utilization among participants within 12 months from enrolment will be assessed. The incremental costs incurred for an additional participant in the CDCC Pilot Scheme to achieve target disease control outcomes after 12 months will be reported as an indicator for cost-effectiveness. Discussion: The quality of care and effectiveness of the CDCC Pilot Scheme in enhancing the health outcomes of the Scheme participants will be examined. Standards of good practice and recommendations for quality enhancement will be established to inform service planning in similar cross-sector screening and management programme. Trial registration: NCT06310148; 2024-03-22.