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Noncommunicable diseases (NCD’s) such as type 2 diabetes and hypertension are increasing in Cambodia. Clinicians in Cambodia do not routinely offer behavioral interventions to address the lifestyle behaviors such as poor nutrition, lack of physical activity and tobacco smoking that contribute to poor outcomes for NCD’s. Behavioral conditions such as depression and substance use disorder that are frequently comorbid with NCD’s also contribute to poor clinical outcomes are also not routinely addressed in medical settings in Cambodia. Integrated healthcare is the systematic, team-based approach to delivering behavioral interventions to address lifestyle and behavioral conditions that underlie poor outcomes for NCD’s delivered by a Behavioral Health Consultant (BHC). Research on type 2 diabetes and hypertension risk factors such as nutrition, physical activity, tobacco smoking and alcohol misuse demonstrates the need for a new workforce of BHC’s to improve quality and outcomes. A model of integrated behavioral health designed by this research team uses a Health Risk Assessment, a social worker or community health worker in the BHC role, and smartphone app platform for patient health self-management is recommended.

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In this article, we describe the hcost program for estimating mean health care costs and incremental cost-effectiveness ratios with possibly censored data. hcost estimates the mean survival time and the mean costs, as well as their variances and covariance, for a given time horizon. If the group variable is specified, hcost will report the differences between two groups, as well as the incremental cost-effectiveness ratio and its confidence interval (optional). hcost can estimate the mean costs using two methods corresponding to different types of data: the Bang and Tsiatis (2000, Biometrika 87: 329–343) estimator using only the total costs or the Zhao and Tian (2001, Biometrics 57: 1002–1008) estimator when cost-history data are available. The hcost program can also be used to specify the annual discounting rates for survival time and costs.