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Are lifestyle interventions in primary care cost-effective?: An analysis based on a Markov model, differences-in-differences approach and the Swedish Björknäs study
Centre for Primary Healthcare Research, Skåne University Hospital, Malmö, Lund University/Region Skåne.
Centre for Primary Healthcare Research, Skåne University Hospital, Malmö, Lund University/Region Skåne.
Centre for Primary Healthcare Research, Skåne University Hospital, Malmö, Lund University/Region Skåne.
Luleå University of Technology, Department of Health Sciences, Health and Rehab.ORCID iD: 0000-0001-8963-2247
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2013 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 8, no 11, article id e80672Article in journal (Refereed) Published
Abstract [en]

Background: 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 Bjorknas 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 Bjorknas study. Methodology/Principal Findings: 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.

Place, publisher, year, edition, pages
2013. Vol. 8, no 11, article id e80672
National Category
Physiotherapy
Research subject
Physiotherapy
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URN: urn:nbn:se:ltu:diva-8934DOI: 10.1371/journal.pone.0080672ISI: 000327143800154Scopus ID: 2-s2.0-84893569579Local ID: 77c4b98d-5a33-4213-a522-ac17a0e031cbOAI: oai:DiVA.org:ltu-8934DiVA, id: diva2:981872
Note

Validerad; 2013; 20131213 (ysko)

Available from: 2016-09-29 Created: 2016-09-29 Last updated: 2018-07-10Bibliographically approved

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Eriksson, Margareta K.

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