ArticleNPJ digital medicine2026
Economic evaluation of telemedicine-based integrated management of atrial fibrillation in rural China: a modeling analysis.
Article in NPJ digital medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
10 authors.
Funding
Abstract
Atrial fibrillation (AF) imposes a substantial disease and economic burden worldwide, particularly in rural areas with limited access to integrated care. The MIRACLE-AF trial demonstrated significant reductions in cardiovascular mortality, stroke, and heart failure or acute coronary syndrome hospitalizations with telemedicine-based, village doctor-led integrated management versus usual care. We conducted an economic evaluation of this management among patients aged ≥65 years in rural China. A Markov model was developed from the healthcare provider perspective to simulate a hypothetical cohort over a 15-year horizon. Outcomes included incremental cost-effectiveness ratios (ICERs) per cardiovascular death avoided and per stroke avoided, and incremental cost-utility ratios (ICURs) per quality-adjusted life-year (QALY) gained. Costs were expressed in 2024 US dollars ($1 = 7.1975 CNY), with a willingness-to-pay threshold of $35,718 (three times rural China's per-capita GDP in 2024). Compared with usual care, telemedicine-based integrated yielded ICERs of $60,692 per cardiovascular mortality and $4,880 per stroke avoided, and a favorable ICUR of $4,554 per QALY gained. Probabilistic sensitivity analysis indicated cost-effective in 97.60% of simulations, with results most sensitive to the number of patients managed per village doctor. These findings support telemedicine-based, village doctor-led integrated AF management as a potential cost-effective strategy in resource-limited rural settings.
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Registered trials
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