The cost of a primary care-based childhood obesity prevention intervention.
The cost of a primary care-based childhood obesity prevention intervention.
复制标题
DOI：
10.1186/1472-6963-14-44
复制
发表时间：
2014-01-29
影响因子：
2.8
通讯作者：
Prosser LA
中科院分区：
文献类型：
--
作者：
Wright DR;Taveras EM;Gillman MW;Horan CM;Hohman KH;Gortmaker SL;Prosser LA
美国儿科指南建议在初级保健环境中进行儿童肥胖咨询。基于初级保健的干预措施可以有效改善健康行为，但也很昂贵。本研究的目的是评估以初级保健为基础的肥胖预防干预措施的成本，该干预措施针对2至6岁肥胖风险较高的儿童，与常规护理相比。High Five for Kids是一项随机分组对照临床试验，旨在通过动机性访谈干预来改变儿童的营养和电视观看习惯。我们从社会角度评估了干预组（n = 253）和常规护理组（n = 192）的访视相关成本，包括提供者产生的直接医疗成本、提供者产生的设备成本、父母时间成本和父母自付成本（2011年美元）。我们进行了净成本分析，使用社会和健康计划成本的角度，并进行了单向的敏感性和不确定性分析的结果。干预组和常规护理组在干预第一年的总成本分别为65，643美元（95% CI [64，522美元，66，842美元]）和12，192美元（95% CI [11，393美元，13，174美元]）。干预组和常规护理组的平均成本分别为每名儿童259美元（95% CI [255美元，264美元]）和63美元（95% CI [59美元，69美元]），每名儿童的增量差异为196美元（95% CI [191美元，202美元]）。干预组的儿童平均参加了4次面对面访问中的2.4次，并收到了2次咨询电话中的0.45次。供应商产生的费用是敏感性分析中费用估计数的主要驱动因素。High Five for Kids是一项资源密集型干预措施。需要进一步的研究来评估干预措施相对于其他儿童肥胖干预措施的成本效益。ClinicalTrials.gov标识符：NCT 00377767。
United States pediatric guidelines recommend that childhood obesity counseling be conducted in the primary care setting. Primary care-based interventions can be effective in improving health behaviors, but also costly. The purpose of this study was to evaluate the cost of a primary care-based obesity prevention intervention targeting children between the ages of two and six years who are at elevated risk for obesity, measured against usual care. High Five for Kids was a cluster-randomized controlled clinical trial that aimed to modify children’s nutrition and TV viewing habits through a motivational interviewing intervention. We assessed visit-related costs from a societal perspective, including provider-incurred direct medical costs, provider-incurred equipment costs, parent time costs and parent out-of-pocket costs, in 2011 dollars for the intervention (n = 253) and usual care (n = 192) groups. We conducted a net cost analysis using both societal and health plan costing perspectives and conducted one-way sensitivity and uncertainty analyses on results. The total costs for the intervention group and usual care groups in the first year of the intervention were $65,643 (95% CI [$64,522, $66,842]) and $12,192 (95% CI [$11,393, $13,174]). The mean costs for the intervention and usual care groups were $259 (95% CI [$255, $264]) and $63 (95% CI [$59, $69]) per child, respectively, for a incremental difference of $196 (95% CI [$191, $202]) per child. Children in the intervention group attended a mean of 2.4 of a possible 4 in-person visits and received 0.45 of a possible 2 counseling phone calls. Provider-incurred costs were the primary driver of cost estimates in sensitivity analyses. High Five for Kids was a resource-intensive intervention. Further studies are needed to assess the cost-effectiveness of the intervention relative to other pediatric obesity interventions. ClinicalTrials.gov Identifier: NCT00377767.
登录
查看更多内容
影响因子：
8
作者：
Barlow, Sarah E.
通讯作者：
Barlow, Sarah E.
（纸）医学工作：了解国际医疗费用。
DOI：
10.1257/jep.25.2.3
发表时间：
2011
期刊：
The journal of economic perspectives : a journal of the American Economic Association
影响因子：
--
作者：
Cutler DM;Ly DP
通讯作者：
Ly DP
DOI：
10.1136/bmj.b3308
发表时间：
2009-09-03
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Wake M;Baur LA;Gerner B;Gibbons K;Gold L;Gunn J;Levickis P;McCallum Z;Naughton G;Sanci L;Ukoumunne OC
通讯作者：
Ukoumunne OC
影响因子：
8
作者：
Yoo BK;Szilagyi PG;Schaffer SJ;Humiston SG;Rand CM;Albertin CS;Vincelli P;Blumkin AK;Shone LP;Coleman MS
通讯作者：
Coleman MS
DOI：
10.1186/1479-5868-4-47
发表时间：
2007-10-01
影响因子：
8.7
作者：
Brown, Henry Shelton, III;Perez, Adriana;Rivera, Roberto
通讯作者：
Rivera, Roberto