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Cost-Effectiveness of Health System and State-Level Strategies to Improve Diet and Reduce Cardiometabolic Diseases

卫生系统的成本效益和改善饮食和减少心血管代谢疾病的国家级战略

基本信息

批准号：
10458609
负责人：
DARIUSH MOZAFFARIAN
金额：
$ 73.67万
依托单位：
TUFTS UNIVERSITY BOSTON
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-08-15 至 2024-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10458609
关键词：
Accountability Address Adopted Advocacy Age Cardiometabolic Disease Chronic Disease Clinical Complex Congresses Data Data Sources Diabetes Mellitus Diet Disincentive Education Electronic Health Record Eligibility Determination Ethnic Origin Farm Federal Government Food Food Policy Future Geographic state Government Grant Health Health Benefit Health Food Health system Healthy Eating Incentives Income Intervention Investigation Legal Measures Media Campaign Medicaid Medical Medicare/Medicaid Medicine Methods Modeling Municipalities Patients Policies Policy Maker Policy Research Population Positioning Attribute Privatization Progress Reports Public Health Quality-Adjusted Life Years Race Research Resources Review Literature Risk Risk Assessment Science Scientist State Government Subgroup Surveys Taxes Testing Time Training Uncertainty Work advocacy organizations authority base comparative cost cost effectiveness disease disparity economic incentive experience experimental study federal policy food insecurity fruits and vegetables health disparity health equity improved incentive program innovation interest method development microcosting nutrition preempt preference programs scale up screening sex sociodemographics success sugar sweetened beverage warning label working group

项目摘要

Project Summary While considerable evidence supports and informs the likely benefits of policy innovations within and outside health systems to improve diet and reduce cardiometabolic diseases (CMD), their impacts on health, disparities, costs, and cost-effectiveness are not well established. Because major diet-related disparities persist, assessing effects of such strategies in at-risk subgroups is crucial. Administrative and legal challenges can strongly influence implementation, scale-up, and sustainability of such strategies, but such considerations have not yet been rigorously assessed. Our specific aims extend our prior analyses of national policies to address crucial questions for health system strategies and state-specific actions and to disseminate this evidence. The aims are 1) to estimate the health impacts, costs, cost-effectiveness, and effects on disparities of specific health system strategies to improve diet and reduce CMD in the US; 2) to estimate the health impacts, costs, cost-effectiveness, and effects on disparities of specific state-level policies to improve diet and reduce CMD in the US; 3) to assess the administrative and legal challenges and feasibility of specific health system and state strategies to improve diet and reduce CMD in the US; and 4) to disseminate our top findings from the prior period, related grants, and this new work to relevant stakeholders in key legislative, agency, and advocacy positions. Building on our prior experience, we will evaluate health system interventions, state interventions, and administrative/legal feasibility. We will define plausible policy effect sizes and their uncertainty based on reviews of literature and expert contacts; and adopt a micro-costing approach using established methods to assess policy costs including by sectors. We will project costs and CMD benefits of each policy, using established modeling approaches, and quantify comparative efficiency measured by ICER comparing each intervention to a base case. Effects on disparities will be evaluated comparing differences in CMD disparities (difference in difference approach) for each action in key population subgroups. We will conduct in-depth administrative and legal analysis to identify the likely conditions for success and the authorities and obstacles for implementation.

项目总结