Feasibility and cost-effectiveness of a hospital-based hepatitis B management model in China: the ‘Hot Wave Project’ experience
摘要
Chronic hepatitis B virus (HBV) infection remains a major burden. The “Hot Wave Project,” a hospital-wide initiative launched in 2022, aims to enhance HBV care by integrating patient education with systematic screening, referral, diagnosis, treatment, and follow-up.
MethodsWe conducted a comparative analysis of hospital-wide HBV care metrics between 2021 (preintervention) and 2024 (postintervention). An interrupted time series (ITS) analysis was conducted on monthly data to evaluate the causal impact of the intervention. A decision-analytic Markov model was used to simulate the cost-effectiveness and epidemiological impact of the project on a hypothetical cohort of one million patients.
ResultsFrom 2021 to 2024, the HBsAg screening rate hospital-wide increased from 11.75% to 15.25%. Referrals of HBsAg-positive patients from nonhepatology departments surged from 9.26% to 17.87% (p < 0.0001), and the overall antiviral treatment rate rose from 71.00% to 80.25%. ITS analysis confirmed that the intervention caused significant immediate increases in screening and referral rates and a sustained acceleration in treatment uptake. Regular follow-up rates increased modestly from 59.96% to 61.5%. The model projected that the 2024 intervention levels would avert 17.4 HBV-related deaths per 100,000 person-years, yielding an incremental cost-effectiveness ratio (ICER) of $5688 per quality-adjusted life year (QALY) gained.
ConclusionThe “Hot Wave Project” is a cost-effective and scalable hospital-based model that significantly improves the HBV care continuum. By enhancing interdisciplinary coordination, this approach offers an adaptable framework to help China advance toward its viral hepatitis elimination targets.
Graphical abstract