Cost-effectiveness of health promotion targeting physical activity and healthy eating in mental health care

被引:20
|
作者
Verhaeghe, Nick [1 ,2 ]
De Smedt, Delphine [1 ]
De Maeseneer, Jan [3 ]
Maes, Lea [1 ]
Van Heeringen, Cornelis [4 ]
Annemans, Lieven [1 ,2 ]
机构
[1] Univ Ghent, Dept Publ Hlth, B-9000 Ghent, Belgium
[2] Vrije Univ Brussel, Dept Med Sociol, B-1090 Jette, Belgium
[3] Univ Ghent, Dept Family Med & Primary Hlth Care, B-9000 Ghent, Belgium
[4] Univ Ghent, Dept Psychiat & Med Psychol, B-9000 Ghent, Belgium
来源
BMC PUBLIC HEALTH | 2014年 / 14卷
关键词
Mental disorders; Cost-effectiveness; Health promotion; Physical activity; Healthy eating; BODY-MASS INDEX; QUALITY-OF-LIFE; RANDOMIZED CONTROLLED-TRIAL; TYPE-2; DIABETES-MELLITUS; WEIGHT-GAIN; BIPOLAR DISORDER; RISK; METAANALYSIS; MORTALITY; OBESITY;
D O I
10.1186/1471-2458-14-856
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: There is a higher prevalence of obesity in individuals with mental disorders compared to the general population. The results of several studies suggested that weight reduction in this population is possible following psycho-educational and/or behavioural weight management interventions. Evidence of the effectiveness alone is however inadequate for policy making. The aim of the current study was to evaluate the cost-effectiveness of a health promotion intervention targeting physical activity and healthy eating in individuals with mental disorders. Methods: A Markov decision-analytic model using a public payer perspective was applied, projecting the one-year results of a 10-week intervention over a time horizon of 20 years, assuming a repeated yearly implementation of the programme. Scenario analysis was applied evaluating the effects on the results of alternative modelling assumptions. One-way sensitivity analysis was performed to assess the effects on the results of varying key input parameters. Results: An incremental cost-effectiveness ratio of 27,096(sic)/quality-adjusted life years (QALY) in men, and 40,139(sic)/QALY in women was found in the base case. Scenario analysis assuming an increase in health-related quality of life as a result of the body mass index decrease resulted in much better cost-effectiveness in both men (3,357(sic)/QALY) and women (3,766(sic)/QALY). The uncertainty associated with the intervention effect had the greatest impact on the model. Conclusions: As far as is known to the authors, this is the first health economic evaluation of a health promotion intervention targeting physical activity and healthy eating in individuals with mental disorders. Such research is important as it provides payers and governments with better insights how to spend the available resources in the most efficient way. Further research examining the cost-effectiveness of health promotion targeting physical activity and healthy eating in individuals with mental disorders is required.
引用
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页数:9
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