Cost-Effectiveness of Family-Based Group Treatment for Child and Parental Obesity
Cost-Effectiveness of Family-Based Group Treatment for Child and Parental Obesity
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DOI：
10.1089/chi.2013.0123
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发表时间：
2014-04-01
影响因子：
2.5
通讯作者：
Finkelstein, Eric
中科院分区：
文献类型：
--
作者：
Epstein, Leonard H.;Paluch, Rocco A.;Finkelstein, Eric
背景：肥胖具有家族性，基于家庭的行为治疗（FBT）与超重/肥胖儿童及其超重/肥胖父母的体重减轻有关。本研究旨在评估FBT与超重/肥胖父母和儿童（PC）单独组治疗相比的成本和成本效益。方法：50名父母超重/肥胖的8- 12岁超重/肥胖儿童被随机分配到12个月的FBT或PC治疗方案。社会成本（付款人加机会成本）的评估是基于两个假设完成的：(1)父母和孩子的项目在不同的日子（PC-1）或(2)父母和孩子的干预措施在同一天的同一地点的连续时间（PC-2）。成本效益是根据每单位变化的社会成本计算的，使用儿童超重百分比和父母体重百分比。结果：每个家庭FBT的平均社会成本为1448美元，PC-1为2260美元（p < 0.001）， PC-2为2124美元（p < 0.001）。FBT的儿童成本效益为209.17美元/超重百分比，而PC-1和PC-2的儿童成本效益分别为1036.50美元/超重百分比和973.98美元/超重百分比。FBT的成本效益为132.97美元/磅，PC-1为373.53美元/磅，PC-2为351.00美元/磅。结论：对于有超重/肥胖儿童和家长的家庭，FBT对父母和孩子的单位减肥成本比单独治疗低。鉴于儿童和成人肥胖率高，FBT可能为肥胖干预提供一个独特的成本效益平台，可以改变超重/肥胖父母及其超重/肥胖子女的体重。
Background: Obesity runs in families, and family-based behavioral treatment (FBT) is associated with weight loss in overweight/obese children and their overweight/obese parents. This study was designed to estimate the costs and cost-effectiveness of FBT compared to separate group treatments of the overweight/obese parent and child (PC).Methods: Fifty overweight/obese 8-to 12-year-old children with overweight/obese parents were randomly assigned to 12 months of either FBT or PC treatment program. Assessment of societal costs (payer plus opportunity costs) were completed based on two assumptions: (1) programs for parent and child were available on separate days (PC-1) or (2) interventions for parent and child were available in the same location at sequential times on the same day (PC-2). Cost-effectiveness was calculated based on societal cost per unit of change using percent overBMI for children and weight for parents.Results: The average societal cost per family was $1,448 for FBT and $2,260 for PC-1 (p < 0.001) and $2,124 for PC-2 (p < 0.001). Child cost-effectiveness for FBT was $209.17/percent overBMI, compared to $1,036.50/percent overBMI for PC-1 and $973.98/percent overBMI for PC-2. Parent cost-effectiveness was $132.97/pound (lb) for FBT and $373.53/lb (PC-1) or $351.00/lb (PC-2).Conclusions: For families with overweight/obese children and parents, FBT presents a lower cost per unit of weight loss for parents and children than treating the parent and child separately. Given the high rates of pediatric and adult obesity, FBT may provide a unique cost-effective platform for obesity intervention that alters weight in overweight/obese parents and their overweight/obese children.