Wang Li Yan, Yang Quanhe, Lowry Richard, Wechsler Howell
Division of Adolescent and School Health, Centers for Disease Control and Prevention, 4770 Buford Highway, MS K-33, Chamblee, GA 30341, USA.
Obes Res. 2003 Nov;11(11):1313-24. doi: 10.1038/oby.2003.178.
To assess the cost-effectiveness and cost-benefit of Planet Health, a school-based intervention designed to reduce obesity in youth of middle-school age children.
Standard cost-effectiveness analysis methods and a societal perspective were used in this study. Three categories of costs were measured: intervention costs, medical care costs associated with adulthood overweight, and costs of productivity loss associated with adulthood overweight. Health outcome was measured as cases of adulthood overweight prevented and quality-adjusted life years (QALYs) saved. Cost-effectiveness ratio was measured as the ratio of net intervention costs to the total number of QALYs saved, and net-benefit was measured as costs averted by the intervention minus program costs.
Under base-case assumptions, at an intervention cost of $33,677 or $14 US dollars per student per year, the program would prevent an estimated 1.9% of the female students (5.8 of 310) from becoming overweight adults. As a result, an estimated 4.1 QALYs would be saved by the program, and society could expect to save an estimated $15,887 USD in medical care costs and $25,104 USD in loss of productivity costs. These findings translated to a cost of $4305 USD per QALY saved and a net saving of $7313 USD to society. Results remained cost-effective under all scenarios considered and remained cost-saving under most scenarios.
The Planet Health program is cost-effective and cost-saving as implemented. School-based prevention programs of this type are likely to be cost-effective uses of public funds and warrant careful consideration by policy makers and program planners.
评估“健康星球”项目的成本效益和成本收益,该项目是一项以学校为基础的干预措施,旨在减少初中年龄段青少年的肥胖问题。
本研究采用标准成本效益分析方法,并从社会角度进行考量。测量了三类成本:干预成本、与成年期超重相关的医疗保健成本以及与成年期超重相关的生产力损失成本。健康结果以预防的成年期超重病例数和节省的质量调整生命年(QALY)来衡量。成本效益比以净干预成本与节省的QALY总数之比来衡量,净收益以干预避免的成本减去项目成本来衡量。
在基本假设情况下,干预成本为33,677美元或每名学生每年14美元,该项目预计可防止1.9%的女学生(310名中的5.8名)成年后超重。因此,该项目预计可节省4.1个QALY,社会预计可节省约15,887美元的医疗保健成本和25,104美元的生产力损失成本。这些结果转化为每节省一个QALY的成本为4305美元,社会净节省7313美元。在所有考虑的情景下,结果均具有成本效益,且在大多数情景下仍具有成本节约效益。
实施后的“健康星球”项目具有成本效益且能节省成本。这种以学校为基础的预防项目可能是有效利用公共资金的方式,值得政策制定者和项目规划者仔细考虑。