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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：
10687059
负责人：
DARIUSH MOZAFFARIAN
金额：
$ 69.11万
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/10687059
关键词：
Accountability Address Adopted Advocacy Age Authorization documentation Cardiometabolic Disease Chronic Disease Clinical Complex Congresses Data Data Sources Diabetes Mellitus Diet Disincentive Disparity Educational Assessment Electronic Health Record Eligibility Determination Equity Ethnic Origin Farm Federal Government Food Food Policy Future Government Grant Health Health Benefit Health Food Health system Healthy Eating Incentives Income Intervention Investigation Legal Measures Media Campaign Medicaid Medical Medicare Medicine Methods Modeling Municipalities Patients Policies Policy Maker Population Positioning Attribute Privatization Progress Reports Public Health Race Research Resources Review Literature Risk Risk Assessment Science Scientist State Government Subgroup Surveys Taxes Testing Training US State Uncertainty Work advocacy organizations authority base comparative cost cost effectiveness cost per quality-adjusted life year disease disparity economic incentive experience experimental study federal policy food insecurity fruits and vegetables health disparity improved incentive program incremental cost innovation interest method development microcosting models and simulation 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.

项目摘要虽然有大量证据支持并说明了内外部政策创新可能带来的好处，卫生系统改善饮食和减少心血管代谢疾病，其对健康的影响，差异、成本和成本效益尚未得到很好的确定。因为与饮食有关的主要差异然而，如果这些战略持续存在，评估这些战略在高危亚组中的效果至关重要。行政和法律的挑战可以强烈影响这些战略的实施，扩大规模和可持续性，但这些考虑因素尚未得到严格评估。我们的具体目标将我们先前对国家政策的分析扩展到解决卫生系统战略和国家具体行动的关键问题，并传播这一点; 证据其目的是1）估计健康影响，成本，成本效益和对差距的影响具体的卫生系统战略，以改善饮食和减少CMD在美国; 2）估计健康影响，成本，成本效益，以及对具体的州一级政策，以改善饮食和减少美国的CMD; 3）评估特定健康的行政和法律的挑战和可行性系统和国家的战略，以改善饮食和减少CMD在美国;和4）传播我们的主要发现从前期，相关赠款，这项新的工作，以相关利益攸关方在关键的立法，机构，宣传阵地。根据我们以前的经验，我们将评估卫生系统干预措施，干预和行政/法律的可行性。我们将定义合理的政策效应大小及其根据对文献和专家联系的审查，制定了评估政策成本的方法，包括按部门评估。我们将预测以下项目的成本和CMD收益：每项政策，使用既定的建模方法，并量化比较效率衡量ICER 将每个干预与基本情况进行比较。对差异的影响将通过比较以下方面的差异来评估：关键人群亚组中每项行动的CMD差异（差异方法差异）。我们将进行深入的行政和法律的分析，以确定成功的可能条件和执行的障碍和障碍。

项目成果

期刊论文数量（38）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Evaluation of health and economic effects of United States school meal standards consistent with the 2020-2025 dietary guidelines for Americans.

DOI：
10.1016/j.ajcnut.2023.05.031
发表时间：
2023-09
期刊：
The American journal of clinical nutrition
影响因子：
0
作者：
通讯作者：

Cost-effectiveness Analysis of Nutrition Facts Added-Sugar Labeling and Obesity-Associated Cancer Rates in the US.

DOI：
10.1001/jamanetworkopen.2021.7501
发表时间：
2021-04-01
期刊：
JAMA network open
影响因子：
13.8
作者：
Du M;Griecci CF;Cudhea FF;Eom H;Kim DD;Wilde P;Wong JB;Wang YC;Michaud DS;Mozaffarian D;Zhang F;Food-PRICE Project
通讯作者：
Food-PRICE Project

A Food is Medicine approach to achieve nutrition security and improve health.

采用“食品即药物”的方法来实现营养安全和改善健康。

DOI：
10.1038/s41591-022-02027-3
发表时间：
2022
期刊：
Nature medicine
影响因子：
82.9
作者：
Mozaffarian,Dariush;Blanck,HeidiM;Garfield,KathrynM;Wassung,Alissa;Petersen,Ruth
通讯作者：
Petersen,Ruth

Health and Economic Impacts of Implementing Produce Prescription Programs for Diabetes in the United States: A Microsimulation Study.

DOI：
10.1161/jaha.122.029215
发表时间：
2023-08
期刊：
JOURNAL OF THE AMERICAN HEART ASSOCIATION
影响因子：
5.4
作者：
Wang, Lu;Lauren, Brianna N.;Hager, Kurt;Zhang, Fang Fang;Wong, John B.;Kim, David D.;Mozaffarian, Dariush
通讯作者：
Mozaffarian, Dariush

Implications of the New Recommendation on Behavioral Counseling Interventions to Promote Healthy Eating and Physical Activity.

关于行为咨询干预措施的新建议对促进健康饮食和身体活动的影响。