oru.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Are Lifestyle Interventions in Primary Care Cost-Effective?: An Analysis Based on a Markov Model, Differences-In-Differences Approach and the Swedish Bjorknas Study
Skåne University Hospital, Malmö, Lund University/Region Skåne, Malmö, Sweden; Lund University, Lund, Sweden.
Skåne University Hospital, Malmö, Lund University/Region Skåne, Malmö, Sweden.
Skåne University Hospital, Malmö, Lund University/Region Skåne, Malmö, Sweden; Lund University, Lund, Sweden; .
Department of Public Health and Department of Research, Norrbotten County Council, Luleå, Sweden; Luleå University of Technology, Luleå, Sweden.
Show others and affiliations
2013 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 8, no 11Article 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.

Conclusions/Significance: The Swedish Bjorknas study appears to reduce demands on societal and health care resources and increase health-related quality of life.

Place, publisher, year, edition, pages
2013. Vol. 8, no 11
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:oru:diva-32924DOI: 10.1371/journal.pone.0080672ISI: 000327143800154OAI: oai:DiVA.org:oru-32924DiVA, id: diva2:683309
Note

Funding Agency: Health Economics Programme (HEP) at Lund University; FAS, 2006-1660; Government Grant for Clinical Research; Skåne Region; Norrbotten Local County Council; Division of Primary Health Care, Lulea, Sweden; Visare Norr; Northern County Councils; Sweden; Heart Foundation of Northern Sweden

Available from: 2014-01-03 Created: 2014-01-03 Last updated: 2018-09-07Bibliographically approved

Open Access in DiVA

No full text in DiVA

Other links

Publisher's full text

Authority records BETA

Hagberg, Lars

Search in DiVA

By author/editor
Hagberg, Lars
By organisation
School of Health and Medical Sciences, Örebro University, Sweden
In the same journal
PLoS ONE
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 42 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf