Vijgen S M C, van Baal P H M, Hoogenveen R T, de Wit G A, Feenstra T L
Centre for Prevention.ealth Services Research, National Institute of Public Health and the Environment, 3720 BA Bilthoven, the Netherlands.
Health Educ Res. 2008 Apr;23(2):310-8. doi: 10.1093/her/cym024. Epub 2007 Aug 4.
Little research has been done to connect health promotion programs to outcomes in terms of life expectancy, health care costs and cost-effectiveness. For a policy maker, economic evaluation may be an important tool to support decisions on how to allocate the health care budget. The aim of this paper was to determine the cost-effectiveness of a Dutch school-based smoking education program. The incremental cost-effectiveness ratio of the school program was estimated at euro19 900 per quality adjusted life year gained. For a complete analysis, not only intervention costs but also savings for smoking-related diseases and differences in total health care costs should be taken into account. As several assumptions had to be made in order to estimate cost-effectiveness, the study outcomes should be interpreted with caution. Main problem in estimating the cost-effectiveness was the lack of proper effectiveness data on daily smokers among adolescents. Absence of specific effectiveness data often is an obstacle in the economic evaluation of public health interventions. While some problems may be the result of insufficient sample size or follow-up, another possible explanation might be the different basic principles of analysis of health promoters and economists.
在将健康促进项目与预期寿命、医疗保健成本及成本效益等结果联系起来方面，所做的研究很少。对于政策制定者而言，经济评估可能是支持有关如何分配医疗保健预算决策的一项重要工具。本文的目的是确定荷兰一项以学校为基础的吸烟教育项目的成本效益。该学校项目的增量成本效益比估计为每获得一个质量调整生命年19,900欧元。为了进行全面分析，不仅要考虑干预成本，还应考虑与吸烟相关疾病的节省费用以及总医疗保健成本的差异。由于为了估计成本效益必须做出若干假设，因此对研究结果的解释应谨慎。估计成本效益的主要问题是缺乏关于青少年日常吸烟者的适当有效性数据。缺乏具体的有效性数据往往是公共卫生干预措施经济评估中的一个障碍。虽然一些问题可能是样本量不足或随访不够的结果，但另一种可能的解释可能是健康促进者和经济学家不同的分析基本原则。
