The COVID-19 pandemic accelerated the use of digital health technologies to improve care access and quality of life. The Korean Ministry of Health and Welfare introduced a home care program for end-stage renal disease patients on peritoneal dialysis (PD), incorporating educational consultations and remote monitoring. This study evaluates the long-term economic effectiveness of this digital health-based home care program. Methods: A Markov model was developed to assess the lifetime cost-effectiveness of the PD home care program. Simulations involved 1,000 patients aged 50 in a PD health state, transitioning annually. Effectiveness was measured in quality-adjusted life years (QALYs), and a cost-utility analysis was performed from a limited societal perspective. The willingness-to-pay (WTP) threshold was US$ 32,255 (gross domestic product per capita) per QALY, with a 4.5% discount rate for both QALYs and costs. Outcomes included the incremental cost-effectiveness ratio (ICER) and incremental net monetary benefit, with scenario, sensitivity, and expected value of perfect information (EVPI) analyses addressing uncertainty. Results: The base case analysis yielded an ICER of $4,895 per QALY, well within the WTP threshold. Sensitivity analysis highlighted PD-associated costs as the most critical parameters. Monte Carlo simulations (10,000 iterations) indicated a 79.0% probability of the home care program being optimal. EVPI analysis suggested an additional $2,963 per patient with perfect parameter information. Conclusion: The PD home care program in Korea appears to be a cost-effective strategy, potentially reducing peritonitis incidence and enhancing healthcare efficiency.

Digital health technologies have been rapidly adopted during the coronavirus disease 2019 pandemic. In Korea, a home care program, including face-to-face educational consultation and remote patient monitoring, was initiated to improve patients’ quality of life. This study focused on patients with end-stage renal disease undergoing peritoneal dialysis to verify the long-term clinical effectiveness of this home care program. Methods: This retrospective cohort study was designed as a pre–post study to analyze the clinical impact of a home care program for patients undergoing peritoneal dialysis in a single tertiary care hospital. A total of 186 patients were selected from June 2017 to May 2022 to identify clinical changes after program implementation by analyzing changes in peritonitis incidence and laboratory test results. Interrupted time series analyses with ordinary least squares linear regression and chi-square tests were used. Results: At baseline, the incidence of peritonitis continuously increased by 0.480 cases per 1,000 patient-months (p = 0.02). After program initiation, the trend significantly decreased by 0.886 cases per 1,000 patient-months (p = 0.02). In addition, the proportion of individuals reaching the clinical target range had increased calcium levels (4.9%p, p = 0.003), stable hemoglobin (1.2%p, p = 0.477), phosphorus (2.8%p, p = 0.09), potassium (–1.6%p, p = 0.22), while parathyroid hormone levels decreased (–6.6%p, p = 0.005). Conclusion: With a reduction in peritonitis incidence and overall improvement in laboratory test results, our study suggests that conducting a home care program for patients undergoing peritoneal dialysis is clinically effective.

Background: Given the importance of continuous self-care for people with type 1 diabetes mellitus (T1DM), the Ministry of Health and Welfare of Korea launched a pilot program for chronic disease management. Herein, we applied a home care pilot program to people with T1DM to investigate its effects. Methods: This retrospective cohort study was conducted at a single tertiary hospital (January 2019 to October 2021). A multidisciplinary team comprising doctors, nurses, and clinical nutritionists provided specialized education and periodically assessed patients’ health status through phone calls or text messages. A linear mixed model adjusting for age, sex, and body mass index was used to analyze the glycemic control changes before and after implementing the program between the intervention and control groups. Results: Among 408 people with T1DM, 196 were enrolled in the intervention group and 212 in the control group. The reduction in glycosylated hemoglobin (HbA1c) after the program was significantly greater in the intervention group than in the control group (estimated marginal mean, –0.57% vs. –0.23%, P=0.008); the same trend was confirmed for glycoalbumin (GA) (–3.2% vs. –0.39%, P<0.001). More patients achieved the target values of HbA1c (<7.0%) and GA (<20%) in the intervention group than in the control group at the 9-month follow-up (34.5% vs. 19.6% and 46.7% vs. 28.0%, respectively). Conclusion The home care program for T1DM was clinically effective in improving glycemic control and may provide an efficient care option for people with T1DM, and positive outcomes are expected to expand the program to include more patients.