Simione Meg, Wagner Sophie, Kistin Caroline J, Egan Kelsey A, Kelly Sheila, Adams William G, Taveras Elsie M, Hur Chin
Department of Pediatrics, Mass General for Children, Boston, Massachusetts.
Department of Pediatrics, Harvard Medical School, Boston, Massachusetts.
JAMA Netw Open. 2025 May 1;8(5):e2510087. doi: 10.1001/jamanetworkopen.2025.10087.
Childhood obesity remains a significant public health challenge, with ongoing racial, ethnic, and socioeconomic disparities in its prevention and treatment. Economic evaluations of pediatric obesity interventions are essential for guiding resource allocation in health care settings.
To develop and analyze a simulation model of the Connect for Health program to estimate the costs of implementing the program and assess its cost-effectiveness.
DESIGN, SETTING, AND PARTICIPANTS: This economic evaluation used a Markov cohort model based on the Connect for Health randomized clinical trial (RCT) conducted from June 2014 through March 2016 and the Connect for Health implementation study conducted at 2 academic medical centers in Boston, MA. The study first estimated costs of implementation for new sites, and then simulated program implementation in a cohort that mirrored the RCT population. Data were analyzed from October 2023 to March 2025.
The Connect for Health pediatric weight management program.
Outcomes include costs associated with program implementation and the incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year (QALY) gained.
This study used a cohort of 2494 individuals to mirror the RCT population and included 1178 female participants (47%), a mean (SD) age of 8.0 (3.0) years, and a mean (SD) body mass index z score of 1.91 (0.56). The costs of implementing the Connect for Health program in primary care settings were estimated at $58 000 in 1-time startup costs and $1300 in ongoing monthly costs. The economic model showed that the Connect for Health strategy had an ICER of $10 554 per QALY gained over 2 years compared with no intervention. The study found a threshold of 534 children in a cohort was needed to effectively amortize costs.
In this economic evaluation of a pediatric weight management program, the Connect for Health program was estimated to be cost-effective. These findings are important for health care systems that serve children who are less likely to receive obesity-related care in making decisions about program adoption.
儿童肥胖仍然是一项重大的公共卫生挑战，在其预防和治疗方面存在持续的种族、族裔和社会经济差异。对儿科肥胖干预措施进行经济评估对于指导医疗保健机构的资源分配至关重要。
开发并分析“健康互联”项目的模拟模型，以估算实施该项目的成本并评估其成本效益。
设计、背景和参与者：这项经济评估使用了一个马尔可夫队列模型，该模型基于2014年6月至2016年3月进行的“健康互联”随机临床试验（RCT）以及在马萨诸塞州波士顿的2家学术医疗中心进行的“健康互联”实施研究。该研究首先估算新站点的实施成本，然后在一个反映RCT人群的队列中模拟项目实施情况。数据于2023年10月至2025年3月进行分析。
“健康互联”儿科体重管理项目。
结局包括与项目实施相关的成本以及每获得一个质量调整生命年（QALY）的增量成本效益比（ICER）。
本研究使用了一个由2494名个体组成的队列来反映RCT人群，其中包括1178名女性参与者（47%），平均（标准差）年龄为8.0（3.0）岁，平均（标准差）体重指数z评分为1.91（0.56）。在初级保健机构实施“健康互联”项目的成本估计为一次性启动成本58000美元和每月持续成本1300美元。经济模型显示，与不进行干预相比，“健康互联”策略在2年内每获得一个QALY的ICER为10554美元。该研究发现，一个队列中需要有534名儿童才能有效摊销成本。
在这项对儿科体重管理项目的经济评估中，“健康互联”项目被估计具有成本效益。这些发现对于为不太可能接受肥胖相关护理的儿童提供服务的医疗保健系统在决定采用该项目时具有重要意义。
