Wilson Kimberly J, Brown H Shelton, Bastida Elena
University of Texas Health Science Center Houston, Austin, TX, USA
University of Texas Health Science Center Houston, Austin, TX, USA.
Health Promot Pract. 2015 Jan;16(1):101-8. doi: 10.1177/1524839914537274. Epub 2014 Jun 3.
The objective of our study was to evaluate the cost-effectiveness of a community-based intervention designed to improve physical activity levels and dietary intake and to reduce diabetes risk in a largely Hispanic population residing along the U.S.-Mexico border.
We forecasted disease outcomes, quality-adjusted life-years (QALYs) gained, and lifetime costs associated with actual and projected attainment of 2% and 5% weight loss taking a societal cost perspective. We extrapolated changes in beverage calorie consumption between baseline and 6-month follow-up to attain projected weight loss measures. Outcomes were projected 5, 10, and 20 years into the future and discounted at a 3.0% rate.
The incremental cost-effectiveness ratio was $57,430 and $61,893, respectively, per QALY gained when compared with usual care for the 2% and 5% weight loss scenarios. The intervention was particularly cost-effective for morbidly obese participants. Cost-effectiveness improves when using 3-year weight loss projections based on changes in sugar-sweetened beverage caloric consumption to $49,478 and $24,092 for the 2% and 5% weight loss scenarios.
This analysis demonstrates that a culturally sensitive community-based weight loss and maintenance intervention can be cost-effective even when healthy weight individuals participate.
我们研究的目的是评估一项基于社区的干预措施的成本效益，该干预措施旨在提高身体活动水平和改善饮食摄入，并降低居住在美国与墨西哥边境的主要为西班牙裔人群患糖尿病的风险。
我们从社会成本角度预测了疾病结局、获得的质量调整生命年（QALY）以及与实际和预计实现2%和5%体重减轻相关的终身成本。我们根据基线和6个月随访之间饮料卡路里摄入量的变化推断出预计的体重减轻措施。对未来5年、10年和20年的结局进行了预测，并按3.0%的贴现率进行贴现。
与常规护理相比，在2%和5%体重减轻方案中，每获得一个QALY的增量成本效益比分别为57,430美元和61,893美元。该干预措施对病态肥胖参与者特别具有成本效益。当根据含糖饮料卡路里摄入量的变化使用3年体重减轻预测时，成本效益有所提高，在2%和5%体重减轻方案中分别为49,478美元和24,092美元。
该分析表明，即使健康体重个体参与其中，一项具有文化敏感性的基于社区的体重减轻及维持干预措施也可能具有成本效益。
