Sanz-Guinea Aitor, Espinosa Maite, Grandes Gonzalo, Sáncheza Álvaro, Martínez Catalina, Pombo Haizea, Bully Paola, Cortada Josep
Primary Care Research Unit of Bizkaia, Basque Healthcare Service, Osakidetza, Bilbao, Spain.
Primary Care Research Unit of Bizkaia, Basque Healthcare Service, Osakidetza, Bilbao, Spain.
Gac Sanit. 2017 Sep-Oct;31(5):404-409. doi: 10.1016/j.gaceta.2016.11.010. Epub 2017 Feb 10.
"Prescribe Vida Saludable" (PVS) is an organisational innovation designed to optimise the promotion of multiple healthy habits in primary healthcare. It aims to estimate the cost effectiveness and cost-utility of prescribing physical activity in the pilot phase of the PVS programme, compared to the routine clinical practice of promoting physical activity in primary healthcare.
An economic evaluation of the quasi-experimental pilot phase of PVS was carried out. In the four control centres, a systematic sample was selected of 194 patients who visited the centre in a single year and who did not comply with physical activity recommendations. In the four intervention centres, 122 patients who received their first physical activity prescription were consecutively enrolled. The costs were evaluated from the perspective of the PVS programme using bottom-up methodology. The effectiveness (proportion of patients who changed their physical activity) as well as the utility were evaluated at baseline and after 3 months. The incremental cost-utility ratio (ICUR) and the incremental cost-effectiveness ratio (ICER) were calculated and a sensitivity analysis was performed with bootstrapping and 1,000 replications.
Information was obtained from 35% of control cases and 62% of intervention cases. The ICUR was €1,234.66/Quality Adjusted Life Years (QALY) and the ICER was €4.12. In 98.3% of the simulations, the ICUR was below the €30,000/QALY threshold.
The prescription of physical activity was demonstrably within acceptable cost-utility limits in the pilot PVS phase, even from a conservative perspective.
“开出健康生活处方”（PVS）是一项组织创新，旨在优化初级医疗保健中多种健康习惯的推广。其目的是评估在PVS计划的试点阶段开出体育活动处方的成本效益和成本效用，与初级医疗保健中推广体育活动的常规临床实践进行比较。
对PVS的准实验试点阶段进行了经济评估。在四个对照中心，从一年中到该中心就诊且未遵守体育活动建议的194名患者中选取了一个系统样本。在四个干预中心，连续招募了122名首次接受体育活动处方的患者。从PVS计划的角度使用自下而上的方法评估成本。在基线和3个月后评估有效性（改变体育活动的患者比例）以及效用。计算增量成本效用比（ICUR）和增量成本效益比（ICER），并使用自举法和1000次重复进行敏感性分析。
从35%的对照病例和62%的干预病例中获得了信息。ICUR为1234.66欧元/质量调整生命年（QALY），ICER为4.12欧元。在98.3%的模拟中，ICUR低于30000欧元/QALY的阈值。
即使从保守的角度来看，在PVS试点阶段，体育活动处方的成本效用显然在可接受的范围内。
