Ronckers Emma T, Groot Wim, Steenbakkers Mieke, Ruland Erik, Ament Andre
Department of Health Organisation, Policy and Economics, Maastricht University, Maastricht, The Netherlands.
BMC Public Health. 2006 Mar 2;6:51. doi: 10.1186/1471-2458-6-51.
Little is known about the costs of community programmes to prevent cardiovascular diseases. The present study calculated the economic costs of all interventions within a Dutch community programme called Hartslag Limburg, in such a way as to facilitate generalisation to other countries. It also calculated the difference between the economic costs and the costs incurred by the coordinating institution.
Hartslag Limburg was a large-scale community programme that consisted of many interventions to prevent cardiovascular diseases. The target population consisted of all inhabitants of the region (n = 180.000). Special attention was paid to reach persons with a low socio-economic status. Costs were calculated using the guidelines for economic evaluation in health care. An overview of the material and staffing input involved was drawn up for every single intervention, and volume components were attached to each intervention component. These data were gathered during to the implementation of the intervention. Finally, the input was valued, using Dutch price levels for 2004.
The economic costs of the interventions that were implemented within the five-year community programme (n = 180,000) were calculated to be about euro900,000. euro555,000 was spent on interventions to change people's exercise patterns, euro250,000 on improving nutrition, euro50,000 on smoking cessation, and euro45,000 on lifestyle in general. The coordinating agency contributed about 10% to the costs of the interventions. Other institutions that were part of the programme's network and external subsidy providers contributed the other 90% of the costs.
The current study calculated the costs of a community programme in a detailed and systematic way, allowing the costs to be easily adapted to other countries and regions. The study further showed that the difference between economic costs and the costs incurred by the coordinating agency can be very large. Cost sharing was facilitated by the unique approach used in the Hartslag Limburg programme.
关于社区预防心血管疾病项目的成本，人们了解甚少。本研究计算了荷兰一个名为“林堡心跳”的社区项目中所有干预措施的经济成本，以便于推广至其他国家。研究还计算了经济成本与协调机构所产生成本之间的差异。
“林堡心跳”是一个大规模社区项目，包含多项预防心血管疾病的干预措施。目标人群为该地区所有居民（共18万）。特别关注了社会经济地位较低的人群。成本按照医疗保健经济评估指南进行计算。针对每一项干预措施，列出了所涉及的物资和人员投入概况，并为每个干预部分附上了数量构成。这些数据在干预措施实施过程中收集。最后，按照2004年荷兰物价水平对投入进行估值。
在为期五年的社区项目（共18万）中实施的干预措施的经济成本计算约为90万欧元。55.5万欧元用于改变人们运动模式的干预措施，25万欧元用于改善营养，5万欧元用于戒烟，4.5万欧元用于总体生活方式干预。协调机构承担了干预措施成本的约10%。该项目网络中的其他机构和外部补贴提供者承担了其余90%的成本。
本研究以详细且系统的方式计算了一个社区项目的成本，使得这些成本能够轻松适用于其他国家和地区。研究还表明，经济成本与协调机构所产生成本之间的差异可能非常大。“林堡心跳”项目所采用的独特方法促进了成本分担。
