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首页> 外文期刊>Health education & behavior: the official publication of the Society for Public Health Education >Costs and Cost-Effectiveness of Targeted, Personalized Risk Information to Increase Appropriate Screening by First-Degree Relatives of People With Colorectal Cancer
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Costs and Cost-Effectiveness of Targeted, Personalized Risk Information to Increase Appropriate Screening by First-Degree Relatives of People With Colorectal Cancer

机译：成本和成本效益的目标,个性化的信息增加风险适当的筛选,一级亲属与结直肠癌的人

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Background. Economic evaluations are less commonly applied to implementation interventions compared to clinical interventions. The efficacy of an implementation strategy to improve adherence to screening guidelines among first-degree relatives of people with colorectal cancer was recently evaluated in a randomized-controlled trial. Using these trial data, we examined the costs and cost-effectiveness of the intervention from societal and health care funder perspectives. Method. In this prospective, trial-based evaluation, mean costs, and outcomes were calculated. The primary outcome of the trial was the proportion of participants who had screening tests in the year following the intervention commensurate with their risk category. Quality-adjusted life years were included as secondary outcomes. Intervention costs were determined from trial records. Standard Australian unit costs for 2016/2017 were applied. Cost-effectiveness was assessed using the net benefit framework. Nonparametric bootstrapping was used to calculate uncertainty intervals (UIs) around the costs and the incremental net monetary benefit statistic. Results. Compared with usual care, mean health sector costs were $17 (95% UI [$14, $24]) higher for those receiving the intervention. The incremental cost-effectiveness ratio for the primary trial outcome was calculated to be $258 (95% UI [$184, $441]) per additional person appropriately screened. The significant difference in adherence to screening guidelines between the usual care and intervention groups did not translate into a mean quality-adjusted life year difference. Discussion. Providing information on both the costs and outcomes of implementation interventions is important to inform public health care investment decisions. Challenges in the application of cost-utility analysis hampered the interpretation of results and potentially underestimated the value of the intervention. Further research in the form of a modeled extrapolation of the intermediate increased adherence effect and distributional cost-effectiveness to include equity requirements is warranted.
机译：背景。用于实现干预措施相比临床干预措施。提高药物依从性的实现策略一级亲属之间检查指导方针结直肠癌患者最近在随机对照试验评估。这些试验数据,我们检查了成本和成本效益的干预社会和卫生保健的资助者的观点。方法。评估,意味着成本,和结果计算。参与者的比例筛选测试后的一年的干预符合他们的风险类别。质量调整生命年被包括二次结果。从试验记录。澳大利亚的单位成本为2016/2017。使用净成本效益评估框架中受益。是用来计算不确定性区间(ui)在成本和增量净货币统计中获益。保健,卫生部门意味着成本是17美元(95%的UI[14美元,美元24])对于那些接受更高干预。比率为主要试验结果计算是258美元(95% UI(184美元,441美元))/额外的人适当的筛选。坚持筛查的重要区别常规治疗和之间的指导方针干预组没有转化为的意思质量调整生命年的区别。讨论。成本和实现的结果告知公众干预是重要的卫生保健投资决策。应用程序的成本效用分析阻碍结果和可能的解释低估的价值干预。进一步研究的形式建模外推的中间增加依从性效应和分配成本效益包括股本要求是十分必要的。

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