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针对饮食障碍和高 BMI 的预防计划的建模成本效益。

The Modeled Cost-Effectiveness of a Prevention Program Targeting Both Eating Disorders and High BMI.

机构信息

Monash University Health Economics Group (MUHEG), School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, Penrith, New South Wales, Australia.

出版信息

Int J Eat Disord. 2024 Sep;57(9):1945-1958. doi: 10.1002/eat.24238. Epub 2024 Jul 8.

Abstract

OBJECTIVE

Prevention programs for eating disorders (EDs) and high body index mass (BMI) have the potential to reduce the onset of these interconnected public health concerns. However, it remains unclear whether routine implementation of such programs would be cost-effective. This study aims to determine the cost-effectiveness of an intervention that aims to prevent both ED and high BMI.

METHOD

A Markov model was developed to evaluate the incremental cost-effectiveness of a targeted school-based program, Healthy Weight, that aims to prevent both EDs and high BMI among Australian adolescents with body image concerns (aged 15-18 years), versus a "no intervention" comparator. A cost-utility analysis was conducted from a "healthcare and education" sector perspective with costs (measured in 2019 Australian dollars) and health impacts modeled over the lifetime of the target population. An incremental cost-effectiveness ratio (ICER), expressed as cost per health-adjusted life year (HALY) gained, was calculated. Sensitivity analyses were done to test model assumptions.

RESULTS

The mean intervention cost and HALYs gained were AUD$2.13 million (95% CI, AUD$1.83-2.43 million) and 146 (95% CI, 90-209), respectively. With healthcare cost-savings (AUD$3.97 million) included, the intervention was predicted to be cost-saving (AUD$1.83 million; 95% CI, AUD$0.51-3.21 million). Primary findings were robust to extensive sensitivity analyses.

DISCUSSION

The Healthy Weight intervention is likely to represent good value-for-money. To ensure the successful implementation of this program at the population level, further research on its feasibility and acceptability among schools and the wider community is required.

摘要

目的

饮食失调(ED)和高身体质量指数(BMI)的预防计划有可能减少这些相互关联的公共卫生问题的发生。然而,目前尚不清楚常规实施此类计划是否具有成本效益。本研究旨在确定旨在预防 ED 和高 BMI 的干预措施的成本效益。

方法

开发了一个马尔可夫模型,以评估针对有身体形象问题的澳大利亚青少年(15-18 岁)的有针对性的基于学校的计划——健康体重(旨在预防 ED 和高 BMI)的增量成本效益,与“无干预”对照组相比。从“医疗保健和教育”部门的角度进行了成本效用分析,成本(以 2019 年澳元衡量)和健康影响在目标人群的一生中进行建模。计算了增量成本效益比(ICER),表示为每获得一个健康调整生命年(HALY)的成本。进行了敏感性分析以检验模型假设。

结果

干预措施的平均干预成本和获得的 HALYs 分别为 2130 万澳元(95%CI,1830-2430 万澳元)和 146(95%CI,90-209)。包括医疗保健成本节省(3970 万澳元)在内,该干预措施预计将具有成本效益(1830 万澳元;95%CI,510 万至 3210 万澳元)。主要发现对广泛的敏感性分析具有稳健性。

讨论

健康体重干预措施可能具有良好的性价比。为了确保该计划在人群层面上的成功实施,需要进一步研究其在学校和更广泛社区中的可行性和可接受性。

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