GC Vijay, Wilson Edward C F, Suhrcke Marc, Hardeman Wendy, Sutton Stephen
Health Economics Group, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK.
Health Economics Group, Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich, UK Cambridge Centre for Health Services Research, Institute of Public Health, University of Cambridge School of Clinical Medicine, Cambridge, UK.
Br J Sports Med. 2016 Apr;50(7):408-17. doi: 10.1136/bjsports-2015-094655. Epub 2015 Oct 5.
To determine whether brief interventions promoting physical activity are cost-effective in primary care or community settings.
Systematic review of economic evaluations.
We searched MEDLINE, EMBASE, PsycINFO, CINAHL, EconLit, SPORTDiscus, PEDro, the Cochrane library, National Health Service Economic Evaluation Database and the Cost-Effectiveness Analysis Registry up to 20 August 2014. Web of Knowledge was used for cross-reference search. We included studies investigating the cost-effectiveness of brief interventions, as defined by National Institute for Health and Care Excellence, promoting physical activity in primary care or the community. Methodological quality was assessed using Drummond's checklist for economic evaluations. Data were extracted from individual studies fulfilling selection criteria using a standardised pro forma. Comparisons of cost-effectiveness and cost-utility ratios were made between studies.
Of 1840 identified publications, 13 studies fulfilled the inclusion criteria describing 14 brief interventions. Studies varied widely in the methods used, such as the perspective of economic analysis, intervention effects and outcome measures. The incremental cost of moving an inactive person to an active state, estimated for eight studies, ranged from £96 to £986. The cost-utility was estimated in nine studies compared with usual care and varied from £57 to £14 002 per quality-adjusted life year; dominant to £6500 per disability-adjusted life year; and £15 873 per life years gained.
Brief interventions promoting physical activity in primary care and the community are likely to be inexpensive compared with usual care. Given the commonly accepted thresholds, they appear to be cost-effective on the whole, although there is notable variation between studies.
确定在初级保健或社区环境中促进身体活动的简短干预措施是否具有成本效益。
经济评估的系统评价。
我们检索了截至2014年8月20日的MEDLINE、EMBASE、PsycINFO、CINAHL、EconLit、SPORTDiscus、PEDro、Cochrane图书馆、国家卫生服务经济评估数据库和成本效益分析登记处。使用Web of Knowledge进行交叉参考搜索。我们纳入了调查由英国国家卫生与临床优化研究所定义的促进初级保健或社区身体活动的简短干预措施成本效益的研究。使用Drummond经济评估清单评估方法学质量。使用标准化表格从符合选择标准的个体研究中提取数据。对各研究之间的成本效益和成本效用比进行了比较。
在1840篇已识别的出版物中，13项研究符合纳入标准，描述了14种简短干预措施。研究在使用的方法上差异很大，如经济分析的视角、干预效果和结果测量。八项研究估计，将一个不活动的人转变为活动状态的增量成本在96英镑至986英镑之间。与常规护理相比，九项研究估计了成本效用，每质量调整生命年从57英镑至14002英镑不等；每伤残调整生命年占主导地位至6500英镑；每获得生命年1587英镑。
与常规护理相比，在初级保健和社区中促进身体活动的简短干预措施可能成本较低。鉴于普遍接受的阈值，它们总体上似乎具有成本效益，尽管各研究之间存在显著差异。
