Promoting health, preventing disease: is there an economic case?
Promoting health, preventing disease: is there an economic case?
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促进健康、预防疾病：有经济理由吗？
DOI：
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
D. McDaid
中科院分区：
文献类型：
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作者：
S. Merkur;F. Sassi;D. McDaid
·对照试验和精心设计的观察性研究提供了证据基础，证明了广泛的健康促进和疾病预防干预措施的有效性，这些干预措施可以解决健康风险因素。这些措施包括减少吸烟和饮酒的风险、增加体育活动和促进更健康的饮食、保护心理和情感健康、减少环境危害和使道路环境更安全。·其中许多行动可能是在卫生部门之外供资和实施的。·还有证据表明，有一些具有成本效益的健康促进和疾病预防干预措施。其中一些干预措施将节省成本，但大多数干预措施将产生额外的健康（和其他）效益，以增加成本。然而，必须谨慎对待这一证据基础，因为许多干预措施只在少数情况下进行了评估，不同的研究采用了不同的方法和假设。·综合行动，例如在烟草、酒精和道路伤害预防领域，往往比单独依靠一项行动更具成本效益。使用税收来影响个人对烟草和酒精的使用以及食物消费的选择，一直被视为促进更好生活方式选择的具有成本效益的干预措施。·关于干预措施的长期成本和效益的许多证据是使用模拟建模方法估计的，这些方法综合了关于有效性、流行病学和成本的数据。这反映了许多公共卫生和健康促进干预措施缺乏长期观察到的有效性数据。这也意味着，决策者需要谨慎对待关于促进健康的干预措施的效果是否持久的假设，例如长期行为改变的可能性。针对儿童的干预措施往往最有可能具有成本效益，因为可以实现健康效益的时间较长。虽然有些干预措施可能需要几十年才能看到成本效益，例如对肥胖风险的影响，但有些健康促进和疾病预防行动在短期内具有成本效益。·有机会投资于具有成本效益的健康促进干预措施，这些措施可以普遍提供，也可以在学校或工作场所提供给目标人群。·所确定的大部分经济证据艾德来自高收入国家开展的研究，很少有研究适用于世卫组织欧洲区域的其他环境。·为了帮助鼓励实施具有成本效益的健康促进和疾病预防行动，强调负责资助这些行动的部门最感兴趣的经济利益是有帮助的。
•There is an evidence base from controlled trials and well-designed observational studies on the effectiveness of a wide range of health promotion and disease prevention interventions that address risk factors to health. These include measures to reduce the risk of smoking and alcohol consumption, increase physical activity and promote more healthy diets, protect psychological and emotional well-being, reduce environmental harms and make road environments safer. •Many of these actions may be both funded and delivered outside of the health sector. •There is also an evidence base suggesting that a number of cost-effective health promotion and disease prevention interventions are available. Some of these interventions will be cost-saving, but most will generate additional health (and other) benefi ts for additional costs. However this evidence base must be treated with caution, given that many interventions have only been assessed in a small number of settings and different methods and assumptions are made in different studies. •Combinations of actions, for example in the areas of tobacco, alcohol and road injury prevention, are often more cost-effective than relying on one action alone. •The use of taxes to infl uence individual choices on the use of tobacco and alcohol, as well as the consumption of food, is consistently seen as a cost effective intervention to promote better lifestyle choices. •Much of the evidence on the long-term costs and benefi ts of interventions has been estimated using simulation modelling approaches synthesizing data on effectiveness, epidemiology and costs. This refl ects the lack of long-term observed effectiveness data for many public health and health promoting interventions. It also means that policy-makers need to be cautious on assumptions made about the persistence of effect of health promoting interventions, e.g. the likelihood of long-term behaviour change. •Interventions targeted at children often have the most potential to be costeffective because of the longer time-frame over which health benefi ts can be realized. •While some interventions may take several decades to be seen to be costeffective, for example impacts on the risk of obesity, there are some health promotion and disease prevention actions that are cost effective in the short term. •There are opportunities to invest in cost-effective health promoting interventions that can be delivered universally as well as to target population groups, for instance in schools or workplaces. •Most of the economic evidence identifi ed is from research undertaken in high-income countries, with very few studies applied to other settings in the WHO European Region. •In order to help encourage the implementation of cost-effective health promotion and disease prevention actions it is helpful to highlight economic benefi ts of most interest to the sectors that are responsible for funding these actions
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DOI：
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发表时间：
2010
期刊：
The journal of mental health policy and economics
影响因子：
--
作者：
Foster,EMichael
通讯作者：
Foster,EMichael
DOI：
--
发表时间：
2011
期刊：
--
影响因子：
--
作者：
A. Alwan
通讯作者：
A. Alwan
增加步行行为的干预措施。
影响因子：
4.1
作者：
Williams,DavidM;Matthews,CharlesE;Rutt,Candace;Napolitano,MelissaA;Marcus,BessH
通讯作者：
Marcus,BessH
影响因子：
12.7
作者：
FLAY, BR
通讯作者：
FLAY, BR
预防青少年吸烟的大众媒体计划：成本和成本效益。
影响因子：
5.2
作者：
Secker-Walker,RH;Worden,JK;Holland,RR;Flynn,BS;Detsky,AS
通讯作者：
Detsky,AS