Effectiveness and cost effectiveness of cardiovascular disease prevention in whole populations: modelling study.
Effectiveness and cost effectiveness of cardiovascular disease prevention in whole populations: modelling study.
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DOI：
10.1136/bmj.d4044
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发表时间：
2011-07-28
期刊：
影响因子：
--
通讯作者：
Capewell S
中科院分区：
文献类型：
--
作者：
Barton P;Andronis L;Briggs A;McPherson K;Capewell S
目的评估旨在预防心血管疾病的全民风险因素减少规划的潜在成本效益。设计经济模型分析。设置英格兰和威尔士。Population人口总数。模型电子表格模型，以量化十年来心血管疾病的减少，假设益处适用于不同年龄和风险群体的男性和女性。主要结局指标：心血管事件的避免、质量调整生命年的增加、医疗费用的节省；估计为达到某一特定结果值得花费多少钱。结果：一个覆盖英格兰和威尔士全体人口（约5000万人）的项目，如果将心血管事件减少1%，与没有额外干预相比，每年将为医疗服务节省至少3000万英镑（3400万欧元；4800万美元）。将人口中的平均胆固醇浓度或血压水平降低5%（其他一些国家已经通过类似的干预措施实现了这一目标），每年将节省至少8000万至1亿英镑。立法或采取其他措施减少3克/天的膳食盐摄入量（目前平均摄入量约为8.5克/天），将防止约3万例心血管事件，每年至少节省4000万英镑。立法将工业反式脂肪酸的摄入量减少约占总能量含量的0.5%，可能会增加约57万生命年，并为NHS每年节省至少2.3亿英镑。结论：任何干预措施，即使在任何主要心血管危险因素中实现了适度的全民减少，也会为NHS节省净成本，并改善健康状况。考虑到这个模型中使用的保守假设，真正的好处可能会更大。
Objective To estimate the potential cost effectiveness of a population-wide risk factor reduction programme aimed at preventing cardiovascular disease. Design Economic modelling analysis. Setting England and Wales. Population Entire population. Model Spreadsheet model to quantify the reduction in cardiovascular disease over a decade, assuming the benefits apply consistently for men and women across age and risk groups. Main outcome measures Cardiovascular events avoided, quality adjusted life years gained, and savings in healthcare costs for a given effectiveness; estimates of how much it would be worth spending to achieve a specific outcome. Results A programme across the entire population of England and Wales (about 50 million people) that reduced cardiovascular events by just 1% would result in savings to the health service worth at least £30m (€34m; $48m) a year compared with no additional intervention. Reducing mean cholesterol concentrations or blood pressure levels in the population by 5% (as already achieved by similar interventions in some other countries) would result in annual savings worth at least £80m to £100m. Legislation or other measures to reduce dietary salt intake by 3 g/day (current mean intake approximately 8.5 g/day) would prevent approximately 30 000 cardiovascular events, with savings worth at least £40m a year. Legislation to reduce intake of industrial trans fatty acid by approximately 0.5% of total energy content might gain around 570 000 life years and generate NHS savings worth at least £230m a year. Conclusions Any intervention that achieved even a modest population-wide reduction in any major cardiovascular risk factor would produce a net cost saving to the NHS, as well as improving health. Given the conservative assumptions used in this model, the true benefits would probably be greater.
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影响因子：
39.3
作者：
Bjorck, Lena;Rosengren, Annika;Capewell, Simon
通讯作者：
Capewell, Simon
DOI：
10.1056/nejmoa0907355
发表时间：
2010-02-18
期刊：
The New England journal of medicine
影响因子：
--
作者：
Bibbins-Domingo K;Chertow GM;Coxson PG;Moran A;Lightwood JM;Pletcher MJ;Goldman L
通讯作者：
Goldman L
DOI：
10.1136/bmj.c2442
发表时间：
2010-05-13
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Collins GS;Altman DG
通讯作者：
Altman DG
分析 1981 年至 2006 年间冰岛 25-74 岁人群冠心病死亡率的大幅下降。
影响因子：
3.7
作者：
Aspelund T;Gudnason V;Magnusdottir BT;Andersen K;Sigurdsson G;Thorsson B;Steingrimsdottir L;Critchley J;Bennett K;O'Flaherty M;Capewell S
通讯作者：
Capewell S
DOI：
10.2471/blt.08.057885
发表时间：
2010-02-01
期刊：
Bulletin of the World Health Organization: International Journal of Public Health
影响因子：
--
作者：
Capewell, Simon;Ford, Earl S;Labarthe, Darwin R
通讯作者：
Labarthe, Darwin R