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英国基于社区的成年人体育活动计划(Be Active)的成本效益:自然实验中的经济分析。

Cost-effectiveness of a community-based physical activity programme for adults (Be Active) in the UK: an economic analysis within a natural experiment.

机构信息

Health Economics Unit, Public Health Building, University of Birmingham, Birmingham, UK.

出版信息

Br J Sports Med. 2014 Feb;48(3):207-12. doi: 10.1136/bjsports-2012-091202. Epub 2012 Jul 13.

Abstract

OBJECTIVE

To determine the cost-effectiveness of a physical activity programme (Be Active) aimed at city-dwelling adults living in Birmingham, UK.

METHODS

Very little is known about the cost-effectiveness of public health programmes to improve city-wide physical activity rates. This paper presents a cost-effectiveness analysis that compares a physical activity intervention (Be Active) with no intervention (usual care) using an economic model to quantify the reduction in disease risk over a lifetime. Metabolic equivalent minutes achieved per week, quality-adjusted life years (QALYs) gained and healthcare costs were all included as the main outcome measures in the model. A cost-benefit analysis was also conducted using 'willingness-to-pay' as a measure of value.

RESULTS

Under base-case assumptions-that is, assuming that the benefits of increased physical activity are sustained over 5 years, participation in the Be Active programme increased quality-adjusted life expectancy by 0.06 years, at an expected discounted cost of £3552, and thus the cost-effectiveness of Be Active is £400 per QALY. When the start-up costs of the programme are removed from the economic model, the cost-effectiveness is further improved to £16 per QALY. The societal value placed on the Be Active programme was greater than the operation cost therefore the Be Active physical activity intervention results in a net benefit to society.

CONCLUSIONS

Participation in Be Active appeared to be cost-effective and cost-beneficial. These results support the use of Be Active as part of a public health programme to improve physical activity levels within the Birmingham-wide population.

摘要

目的

确定针对英国伯明翰市居住的城市成年人的身体活动计划(Be Active)的成本效益。

方法

公众健康计划提高城市整体身体活动率的成本效益知之甚少。本文提出了一项成本效益分析,该分析将身体活动干预(Be Active)与无干预(常规护理)进行了比较,使用经济模型来量化一生中降低疾病风险的程度。每周达到的代谢当量分钟数、质量调整生命年(QALY)和医疗保健成本均作为模型中的主要结果指标。还进行了成本效益分析,使用“支付意愿”作为价值衡量标准。

结果

在基本假设下,即假设增加身体活动的益处可持续 5 年,参加 Be Active 计划可使质量调整预期寿命延长 0.06 年,预计贴现成本为 3552 英镑,因此 Be Active 的成本效益为每 QALY 400 英镑。当从经济模型中去除该计划的启动成本时,成本效益进一步提高到每 QALY 16 英镑。社会对 Be Active 计划的重视程度超过了运营成本,因此 Be Active 身体活动干预对社会产生了净收益。

结论

参加 Be Active 似乎具有成本效益和成本效益。这些结果支持将 Be Active 用作改善伯明翰全市人口身体活动水平的公共卫生计划的一部分。

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