Are lifestyle interventions in primary care cost-effective?--An analysis based on a Markov model, differences-in-differences approach and the Swedish Björknäs study.

<h4>Background</h4>Lifestyle interventions affect patients' risk factors for metabolic syndrome (MeSy), a pre-stage to cardiovascular diseases, diabetes and related complications. An effective lifestyle intervention is the Swedish Björknäs intervention, a 3-year randomized controlle...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Sanjib Saha, Katarina Steen Carlsson, Ulf-G Gerdtham, Margareta K Eriksson, Lars Hagberg, Mats Eliasson, Pia Johansson
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/716d5dbcdd684624873840e0abb832dc
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:716d5dbcdd684624873840e0abb832dc
record_format	dspace
spelling	oai:doaj.org-article:716d5dbcdd684624873840e0abb832dc2021-11-18T08:46:24ZAre lifestyle interventions in primary care cost-effective?--An analysis based on a Markov model, differences-in-differences approach and the Swedish Björknäs study.1932-620310.1371/journal.pone.0080672https://doaj.org/article/716d5dbcdd684624873840e0abb832dc2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24244703/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>Lifestyle interventions affect patients' risk factors for metabolic syndrome (MeSy), a pre-stage to cardiovascular diseases, diabetes and related complications. An effective lifestyle intervention is the Swedish Björknäs intervention, a 3-year randomized controlled trial in primary care for MeSy patients. To include future disease-related cost and health consequences in a cost-effectiveness analysis, a simulation model was used to estimate the short-term (3-year) and long-term (lifelong) cost-effectiveness of the Björknäs study.<h4>Methodology/ principal findings</h4>A Markov micro-simulation model was used to predict the cost and quality-adjusted life years (QALYs) for MeSy-related diseases based on ten risk factors. Model inputs were levels of individual risk factors at baseline and at the third year. The model estimated short-term and long-term costs and QALYs for the intervention and control groups. The cost-effectiveness of the intervention was assessed using differences-in-differences approach to compare the changes between the groups in the health care and societal perspectives, using a 3% discount rate. A 95% confidence interval (CI), based on bootstrapping, and sensitivity analyses describe the uncertainty in the estimates. In the short-term, costs are predicted to increase over time in both groups, but less in the intervention group, resulting in an average cost saving/reduction of US$-700 (in 2012, US$1=six point five seven SEK) and US$-500, in the societal and health care perspectives. The long-term estimate also predicts increased costs, but considerably less in the intervention group: US$-7,300 (95% CI: US$-19,700 to US$-1,000) in the societal, and US$-1,500 (95% CI: US$-5,400 to US$2,650) in the health care perspective. As intervention costs were US$211 per participant, the intervention would result in cost saving. Furthermore, in the long-term an estimated 0.46 QALYs (95% CI: 0.12 to 0.69) per participant would be gained.<h4>Conclusions/ significance</h4>The Swedish Björknäs study appears to reduce demands on societal and health care resources and increase health-related quality of life.Sanjib SahaKatarina Steen CarlssonUlf-G GerdthamMargareta K ErikssonLars HagbergMats EliassonPia JohanssonPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 11, p e80672 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sanjib Saha Katarina Steen Carlsson Ulf-G Gerdtham Margareta K Eriksson Lars Hagberg Mats Eliasson Pia Johansson Are lifestyle interventions in primary care cost-effective?--An analysis based on a Markov model, differences-in-differences approach and the Swedish Björknäs study.
description	<h4>Background</h4>Lifestyle interventions affect patients' risk factors for metabolic syndrome (MeSy), a pre-stage to cardiovascular diseases, diabetes and related complications. An effective lifestyle intervention is the Swedish Björknäs intervention, a 3-year randomized controlled trial in primary care for MeSy patients. To include future disease-related cost and health consequences in a cost-effectiveness analysis, a simulation model was used to estimate the short-term (3-year) and long-term (lifelong) cost-effectiveness of the Björknäs study.<h4>Methodology/ principal findings</h4>A Markov micro-simulation model was used to predict the cost and quality-adjusted life years (QALYs) for MeSy-related diseases based on ten risk factors. Model inputs were levels of individual risk factors at baseline and at the third year. The model estimated short-term and long-term costs and QALYs for the intervention and control groups. The cost-effectiveness of the intervention was assessed using differences-in-differences approach to compare the changes between the groups in the health care and societal perspectives, using a 3% discount rate. A 95% confidence interval (CI), based on bootstrapping, and sensitivity analyses describe the uncertainty in the estimates. In the short-term, costs are predicted to increase over time in both groups, but less in the intervention group, resulting in an average cost saving/reduction of US$-700 (in 2012, US$1=six point five seven SEK) and US$-500, in the societal and health care perspectives. The long-term estimate also predicts increased costs, but considerably less in the intervention group: US$-7,300 (95% CI: US$-19,700 to US$-1,000) in the societal, and US$-1,500 (95% CI: US$-5,400 to US$2,650) in the health care perspective. As intervention costs were US$211 per participant, the intervention would result in cost saving. Furthermore, in the long-term an estimated 0.46 QALYs (95% CI: 0.12 to 0.69) per participant would be gained.<h4>Conclusions/ significance</h4>The Swedish Björknäs study appears to reduce demands on societal and health care resources and increase health-related quality of life.
format	article
author	Sanjib Saha Katarina Steen Carlsson Ulf-G Gerdtham Margareta K Eriksson Lars Hagberg Mats Eliasson Pia Johansson
author_facet	Sanjib Saha Katarina Steen Carlsson Ulf-G Gerdtham Margareta K Eriksson Lars Hagberg Mats Eliasson Pia Johansson
author_sort	Sanjib Saha
title	Are lifestyle interventions in primary care cost-effective?--An analysis based on a Markov model, differences-in-differences approach and the Swedish Björknäs study.
title_short	Are lifestyle interventions in primary care cost-effective?--An analysis based on a Markov model, differences-in-differences approach and the Swedish Björknäs study.
title_full	Are lifestyle interventions in primary care cost-effective?--An analysis based on a Markov model, differences-in-differences approach and the Swedish Björknäs study.
title_fullStr	Are lifestyle interventions in primary care cost-effective?--An analysis based on a Markov model, differences-in-differences approach and the Swedish Björknäs study.
title_full_unstemmed	Are lifestyle interventions in primary care cost-effective?--An analysis based on a Markov model, differences-in-differences approach and the Swedish Björknäs study.
title_sort	are lifestyle interventions in primary care cost-effective?--an analysis based on a markov model, differences-in-differences approach and the swedish björknäs study.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/716d5dbcdd684624873840e0abb832dc
work_keys_str_mv	AT sanjibsaha arelifestyleinterventionsinprimarycarecosteffectiveananalysisbasedonamarkovmodeldifferencesindifferencesapproachandtheswedishbjorknasstudy AT katarinasteencarlsson arelifestyleinterventionsinprimarycarecosteffectiveananalysisbasedonamarkovmodeldifferencesindifferencesapproachandtheswedishbjorknasstudy AT ulfggerdtham arelifestyleinterventionsinprimarycarecosteffectiveananalysisbasedonamarkovmodeldifferencesindifferencesapproachandtheswedishbjorknasstudy AT margaretakeriksson arelifestyleinterventionsinprimarycarecosteffectiveananalysisbasedonamarkovmodeldifferencesindifferencesapproachandtheswedishbjorknasstudy AT larshagberg arelifestyleinterventionsinprimarycarecosteffectiveananalysisbasedonamarkovmodeldifferencesindifferencesapproachandtheswedishbjorknasstudy AT matseliasson arelifestyleinterventionsinprimarycarecosteffectiveananalysisbasedonamarkovmodeldifferencesindifferencesapproachandtheswedishbjorknasstudy AT piajohansson arelifestyleinterventionsinprimarycarecosteffectiveananalysisbasedonamarkovmodeldifferencesindifferencesapproachandtheswedishbjorknasstudy
_version_	1718421328432726016

Are lifestyle interventions in primary care cost-effective?--An analysis based on a Markov model, differences-in-differences approach and the Swedish Björknäs study.

Ejemplares similares