Deakin Health Economics, School of Health and Social Development, Institute for Health Transformation, Deakin University, Geelong, Victoria, VIC 3217, Australia.
Global Obesity Centre, Institute for Health Transformation, Deakin University, Geelong, Victoria, VIC 3217, Australia.
Int J Environ Res Public Health. 2021 Feb 2;18(3):1356. doi: 10.3390/ijerph18031356.
While the number of retail interventions with impacts on diet- and/or health-related outcomes is increasing, the economic evaluation literature is limited. This review investigated (i) the cost-effectiveness of health-promoting food retail interventions and (ii) key assumptions adopted in these evaluations.
A systematic review of published academic studies was undertaken (CRD42020153763). Fourteen databases were searched. Eligible studies were identified, analysed, and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines.
Eight studies that evaluated 30 retail interventions were included in the review. Common outcomes reported were cost per healthy food item purchased/served or cost per disability-adjusted life year (DALY) averted. Four studies undertook cost-utility analyses and half of these studies concluded that retail interventions were cost-effective in improving health outcomes. Most studies did not state any assumptions regarding compensatory behaviour (i.e., purchases/consumption of non-intervention foods or food purchases/consumption from non-intervention settings) and presumed that sales data were indicative of consumption.
The cost-effectiveness of retail-based health-promoting interventions is inconclusive. Future health-promoting retail interventions should regularly include an economic evaluation which addresses key assumptions related to compensatory behaviour and the use of sales data as a proxy for consumption.
虽然具有改善饮食和/或健康相关结果的零售干预措施的数量在不断增加，但相关经济评估文献却很有限。本综述调查了（i）促进健康的食品零售干预措施的成本效益，以及（ii）这些评估中采用的关键假设。
系统检索了已发表的学术研究（CRD42020153763）。对 14 个数据库进行了搜索。符合条件的研究根据系统评价和荟萃分析的首选报告项目（PRISMA）指南进行了识别、分析和报告。
综述纳入了 8 项评估 30 项零售干预措施的研究。常见的报告结果是每购买/供应一份健康食品的成本/每避免一个残疾调整生命年（DALY）的成本。有 4 项研究进行了成本效益分析，其中一半的研究结论认为零售干预措施在改善健康结果方面具有成本效益。大多数研究没有说明关于补偿行为的任何假设（即，对非干预食品的购买/消费或从非干预环境购买/消费食物），并假定销售数据能反映消费情况。
基于零售的促进健康的干预措施的成本效益尚不确定。未来的促进健康的零售干预措施应定期进行经济评估，以解决与补偿行为相关的关键假设问题，并使用销售数据作为消费的替代指标。
