Cost-effectiveness of a statewide public health intervention to reduce cardiovascular disease risk

Cost-effectiveness of a statewide public health intervention to reduce cardiovascular disease risk

Blog Article

Abstract Background The cost-effectiveness of community health worker (CHW)-based cardiovascular disease (CVD) risk-reduction interventions is not well established.Colorado Heart Healthy Solutions is a CHW-based intervention designed to reduce modifiable CVD risk factors.This program has previously demonstrated success, but the cost-effectiveness is unknown.

CHW-based interventions are potentially attractive complements to healthcare delivery because laypersons implement the intervention at a lower cost relative to medical care and may be attractive in rural settings with limited clinical resources.Methods CHWs performed screenings and provided ongoing participant support within predominantly rural communities.A point-of-service software tool was used to generate BATH 10-year Framingham CVD risk scores and assist CHWs to make medical referrals and provide ongoing individualized support for lifestyle changes.

A sample of program participants returned for reassessment of risk factors.We calculated quality-adjusted life years (QALYs) gained and program costs using a Markov model.Transition probabilities were calculated using Framingham risk equations or derived from the literature using the observed mean reduction in 10-year CVD risk score over of 37- months follow-up.

Program cost-effectiveness was calculated for both at-risk (abnormal baseline CVD risk factors) and overall program populations.Results The base-case scenario evaluating a 52-year-old male participant revealed an incremental cost savings of $3576 and a gain of 0.16 QALYs associated with the intervention.

Cost savings were greater in at-risk populations.The economic dominance of the model was robust in multiple sensitivity analyses.Conclusions A community-based CVD intervention demonstrated to reduce CVD risk is cost-effective.

This suggests that population-based public health programs may have the potential to complement primary care preventative services to improve health and reduce the burden of Womens Bottoms traditional medical care.