Briggs Adam D M, Wolstenholme Jane, Blakely Tony, Scarborough Peter
BHF Centre on Population Approaches for Non-Communicable Disease Prevention (BHF CPNP), Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF UK.
Health Economics Research Centre (HERC), Nuffield Department of Population Health, University of Oxford, Oxford, UK.
Popul Health Metr. 2016 May 4;14:17. doi: 10.1186/s12963-016-0085-1. eCollection 2016.
Non-communicable diseases are the leading global causes of mortality and morbidity. Growing pressures on health services and on social care have led to increasing calls for a greater emphasis to be placed on prevention. In order for decisionmakers to make informed judgements about how to best spend finite public health resources, they must be able to quantify the anticipated costs, benefits, and opportunity costs of each prevention option available. This review presents a taxonomy of epidemiological model structures and applies it to the economic evaluation of public health interventions for non-communicable diseases. Through a novel discussion of the pros and cons of model structures and examples of their application to public health interventions, it suggests that individual-level models may be better than population-level models for estimating the effects of population heterogeneity. Furthermore, model structures allowing for interactions between populations, their environment, and time are often better suited to complex multifaceted interventions. Other influences on the choice of model structure include time and available resources, and the availability and relevance of previously developed models. This review will help guide modelers in the emerging field of public health economic modeling of non-communicable diseases.
非传染性疾病是全球死亡和发病的主要原因。卫生服务和社会护理面临的压力日益增大,这导致越来越多的人呼吁更加重视预防工作。为了使决策者能够就是否最好地使用有限的公共卫生资源做出明智的判断,他们必须能够量化每种可用预防方案的预期成本、效益和机会成本。本综述提出了一种流行病学模型结构的分类法,并将其应用于非传染性疾病公共卫生干预措施的经济评估。通过对模型结构的优缺点进行新颖的讨论,并举例说明其在公共卫生干预措施中的应用,结果表明,在估计人群异质性的影响方面,个体水平模型可能优于人群水平模型。此外,考虑人群、其环境和时间之间相互作用的模型结构通常更适合复杂的多方面干预措施。对模型结构选择的其他影响因素包括时间和可用资源,以及先前开发模型的可用性和相关性。本综述将有助于指导非传染性疾病公共卫生经济建模这一新兴领域的建模人员。
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