Interuniversity Centre for Health Economics Research (I-CHER), Department of Public Health and Primary Care, Ghent University, Corneel Heymanslaan 10, 9000 Ghent, Belgium.
Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Herestraat 49, O&N2 Bus 521, Leuven 3000, Belgium.
Eur J Public Health. 2022 Feb 1;32(1):87-94. doi: 10.1093/eurpub/ckab189.
This systematic review aimed to provide an overview of the existing literature on cost-effectiveness of exercise referral schemes (ERSs).
A systematic search was performed in MEDLINE, EMBASE, EconLit, Web of Science and PsycINFO. Main inclusion criteria were: (1) insufficiently active people; (2) ERSs and (3) full health economic evaluations. No publication year limits were applied. The methodological quality was assessed independently by two reviewers using the Consensus Health Economic Criteria (CHEC) checklist.
Fifteen eligible publications were retrieved, presenting results of 12 different studies. Compared with usual care, ERSs were found to be cost-effective in a majority of the analyses, but with modest health gains and costs per individual. These cost-effectiveness results were also sensitive to small changes in input parameters. Two studies found that ERSs combined with a pedometer/accelerometer are cost-effective, compared with usual ERS practice. Two other studies found that an ERS with phone support and an ERS with face-to-face support might be equally effective, with similar costs.
Although the literature demonstrated that ERSs could be cost-effective compared with usual care, these results were not robust. Based on a small number of studies, ERSs could be optimized by using tracking devices, or by providing a choice to the participants about the delivery mode. There is need for clarity on the effectiveness of and attendance to ERS, as more certainty about these key input parameters will strengthen health-economic evidence, and thus will allow to provide a clearer message to health policy-makers.
本系统评价旨在提供关于运动推荐计划（ERS）成本效益的现有文献综述。
在 MEDLINE、EMBASE、EconLit、Web of Science 和 PsycINFO 中进行了系统搜索。主要纳入标准为：（1）活动不足的人群；（2）ERS；（3）完整的健康经济评估。未应用发表年份限制。两位评审员使用共识健康经济标准（CHEC）清单独立评估方法学质量。
共检索到 15 篇符合条件的文献，呈现了 12 项不同研究的结果。与常规护理相比，ERS 在大多数分析中被认为具有成本效益，但个人的健康获益和成本都较低。这些成本效益结果对输入参数的微小变化也很敏感。两项研究发现，ERS 与计步器/加速度计相结合比常规 ERS 实践更具成本效益。另外两项研究发现，具有电话支持的 ERS 和具有面对面支持的 ERS 可能同样有效，成本相似。
尽管文献表明 ERS 与常规护理相比可能具有成本效益，但这些结果并不稳健。基于少数研究，ERS 可以通过使用跟踪设备或为参与者提供交付模式选择进行优化。需要明确 ERS 的有效性和参与度，因为这些关键输入参数的确定性提高将加强健康经济证据，从而为卫生政策制定者提供更清晰的信息。
