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Med."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>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 \u226565 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\u2009=\u20097.1975 CNY), with a willingness-to-pay threshold of $35,718 (three times rural China\u2019s 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.<\/jats:p>","DOI":"10.1038\/s41746-026-02772-6","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T17:06:20Z","timestamp":1779210380000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Economic evaluation of telemedicine-based integrated management of atrial fibrillation in rural China: a modeling analysis"],"prefix":"10.1038","volume":"9","author":[{"given":"Wen","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingfang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuxuan","family":"Cai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Chu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shimeng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihang","family":"Peng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y. 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