A COST-EFFECTIVENESS ANALYSIS OF EXERCISE AS A HEALTH PROMOTION ACTIVITY
A COST-EFFECTIVENESS ANALYSIS OF EXERCISE AS A HEALTH PROMOTION ACTIVITY
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DOI：
10.2105/ajph.78.11.1417
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发表时间：
1988-11-01
影响因子：
12.7
通讯作者：
WARNER, KE
中科院分区：
文献类型：
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作者：
HATZIANDREU, EI;KOPLAN, JP;WARNER, KE
我们使用成本效益分析来评估运动对预防冠心病（CHD）的健康和经济影响。我们假设不锻炼者发生冠心病事件的相对危险度为2.0。两个假设的队列（一个有运动，另一个没有运动）的1,000名35岁的男性被跟踪了30年，以观察CHD事件数量，预期寿命和质量调整的预期寿命的差异。我们以慢跑为例来计算成本、受伤率、坚持率和所花时间的价值。考虑了与运动、损伤和治疗冠心病相关的直接和间接成本。我们估计，在30年的研究期间，定期锻炼会减少78.1例CHD事件，增加1.138.3个质量调整生命年（QDs）。根据我们的基本假设，其中包括间接成本，如运动所花费的时间，运动不会产生经济节约。然而，与其他冠心病预防或治疗干预措施相比，每QALY获得的成本为11，313美元。花费的时间价值是一个关键因素，影响锻炼是否是一种节省成本的活动。在另一种模式中，队列中的所有成员都进行一年的锻炼，然后只有那些喜欢或中立的人继续锻炼，锻炼产生净经济储蓄并降低发病率。
We used cost-effectiveness analysis to estimate the health and economic implications of exercise in preventing coronary heart disease (CHD). We assumed that nonexercisers have a relative risk of 2.0 for a CHD event. Two hypothetical cohorts (one with exercise and the other without exercise) of 1,000 35-year-old men were followed for 30 years to observe differences in the number of CHD events, life expectancy, and quality-adjusted life expectancy. We used jogging as an example to calculate cost, injury rates, adherence, and the value of time spent. Both direct and indirect costs associated with exercise, injury, and treating CHD were considered. We estimate that exercising regularly results in 78.1 fewer CHD events and 1.138.3 Quality Adjusted Life Years (QALYs) gained over the 30-year study period. Under our base case assumptions, which include indirect costs such as time spent in exercise, exercise does not produce economic savings. However, the cost per QALY gained of $11,313 is favorable when compared with other preventive or therapeutic interventions for CHD. The value of time spent is a crucial factor, influencing whether exercise is a cost-saving activity. In an alternative model, where all members of the cohort exercise for one year, and then only those who like it or are neutral continue, exercise produces net economic savings as well as reducing morbidity.