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Báo cáo y học: "Targeted versus universal prevention. a resource allocation model to prioritize cardiovascular preventio"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Targeted versus universal prevention. a resource allocation model to prioritize cardiovascular prevention. | Feenstra et al. Cost Effectiveness and Resource Allocation 2011 9 14 http www.resource-allocation.eom content 9 1 14 COST EFFECTIVENESS AND RESOURCE ALLOCATION RESEARCH Open Access Targeted versus universal prevention. a resource allocation model to prioritize cardiovascular prevention 1.2 1.3 1 4 Talitha L Feenstra 1 Pieter M van Baal 1 Monique O Jacobs-van der Bruggen Rudolf T Hoogenveen Geert-Jan Kommer5 and Caroline A Baan1 6 Abstract Background Diabetes mellitus brings an increased risk for cardiovascular complications and patients profit from prevention. This prevention also suits the general population. The question arises what is a better strategy target the general population or diabetes patients. Methods A mathematical programming model was developed to calculate optimal allocations for the Dutch population of the following interventions smoking cessation support diet and exercise to reduce overweight statins and medication to reduce blood pressure. Outcomes were total lifetime health care costs and QALYs. Budget sizes were varied and the division of resources between the general population and diabetes patients was assessed. Results Full implementation of all interventions resulted in a gain of 560 000 QALY at a cost of 640 per capita about 12 900 per QALY on average. The large majority of these QALY gains could be obtained at incremental costs below 20 000 per QALY. Low or high budgets below 9 or above 100 per capita were predominantly spent in the general population. Moderate budgets were mostly spent in diabetes patients. Conclusions Major health gains can be realized efficiently by offering prevention to both the general and the diabetic population. However a priori setting a specific distribution of resources is suboptimal. Resource allocation models allow accounting for capacity constraints and program size in addition to efficiency. Background ifestyle risk factors especially a high body weight play an important role in the development of diabetes