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生活方式行为改变计划对医疗保健成本的影响:来自荷兰一款开放获取移动健康应用程序的准实验性现实世界证据。

The impact of a lifestyle behaviour change program on healthcare costs: Quasi-experimental real-world evidence from an open-access mobile health app in the Netherlands.

作者信息

Agachi Elena, Mierau Jochen O, van Ittersum Koert, Bijmolt Tammo H A

机构信息

Faculty of Economics and Business, University of Groningen, PO Box 800, Groningen 9700 AV, The Netherlands.

Faculty of Economics and Business, University of Groningen, Groningen, The Netherlands; Team Strategy & External Relations, University Medical Center Groningen, Groningen, The Netherlands; Lifelines Cohort Study and Biobank, Roden, The Netherlands.

出版信息

Prev Med. 2024 Dec;189:108174. doi: 10.1016/j.ypmed.2024.108174. Epub 2024 Nov 10.

Abstract

OBJECTIVE

Recognizing the substantial role of modifiable risk factors such as physical inactivity, unhealthy diets, and substance use in driving global healthcare expenses, this study aims to assess the impact of a lifestyle behaviour change mobile health (mHealth) app on healthcare costs within a real-world setting.

METHODS

Employing a difference-in-difference approach, this research compared healthcare costs between users of an mHealth app (treatment group) and a propensity score-matched control group of non-users. The study included data from 15,506 participants in the Netherlands, covering healthcare cost records collected from 2015 to 2019.

RESULTS

The implementation of the mHealth app was linked to a steady reduction in healthcare costs, achieving a 4.9 % decrease (β=-0.05,95%CI:-0.10to0.00) during the first year following the program's implementation, and a further 5.3 % decrease (β=-0.05,95%CI:-0.10to-0.00) in the second year. This healthcare costs reduction is associated with lower expenses for general practitioner services as well as diminished specialist visits. Additionally, increased app use led to further cost reductions, with frequency of use proving more important than intensity.

CONCLUSIONS

This study demonstrates that a behaviour change mHealth app is linked to significant reductions in healthcare costs, with more frequent and intense use leading to greater savings. Given their relatively low cost and ability to reach diverse population groups, such apps not only enhance individual health outcomes but can also serve as effective policy tools for large-scale health promotion, supporting broader societal health improvements.

摘要

目的

鉴于诸如缺乏体育活动、不健康饮食和物质使用等可改变的风险因素在推动全球医疗费用方面发挥的重要作用,本研究旨在评估一款生活方式行为改变移动健康(mHealth)应用程序在现实环境中对医疗费用的影响。

方法

本研究采用差异分析方法,比较了mHealth应用程序用户(治疗组)与倾向得分匹配的非用户对照组之间的医疗费用。该研究纳入了荷兰15506名参与者的数据,涵盖了2015年至2019年收集的医疗费用记录。

结果

mHealth应用程序的实施与医疗费用的稳步降低相关,在该计划实施后的第一年,医疗费用下降了4.9%(β=-0.05,95%CI:-0.10至0.00),在第二年又进一步下降了5.3%(β=-0.05,95%CI:-0.10至-0.00)。这种医疗费用的降低与全科医生服务费用的降低以及专科就诊次数的减少有关。此外,应用程序使用的增加导致了进一步的成本降低,使用频率比使用强度更为重要。

结论

本研究表明,一款行为改变mHealth应用程序与医疗费用的显著降低相关,使用频率越高、强度越大,节省的费用就越多。鉴于此类应用程序成本相对较低且能够覆盖不同人群,它们不仅能改善个人健康状况,还可作为大规模健康促进的有效政策工具,支持更广泛的社会健康改善。

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