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Optimising health care within given budgets: primary prevention of cardiovascular disease in different regions of Sweden
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Centre for Epidemiology, National Board of Health and Welfare, SE-106 30, Stockholm, Sweden.
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin, Epidemiologi och folkhälsovetenskap.ORCID-id: 0000-0002-1633-2179
Umeå universitet, Medicinska fakulteten, Institutionen för folkhälsa och klinisk medicin. Centre for Epidemiology, National Board of Health and Welfare, SE-106 30, Stockholm, Sweden.
2006 (Engelska)Ingår i: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 75, nr 2, s. 214-229Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

This study investigated the consequences of applying strict health maximisation to the choice between three different interventions with a defined budget. We analysed three interventions or preventing cardiovascular diseases, through doctor's advice on smoking cessation, through blood-pressure-lowering drugs. and through lipid-lowering drugs. A state transition model has been used to estimate the cost-utility ratios for entire population in three different county Councils in Sweden, where the populations were stratified into mutually excluding risk groups. The incremental cost-utility ratios are being presented in a league table and combined with the local resources and the local epidemiological data as a proxy for need for treatment, All interventions with an incremental cost-utility ratio exceeding the threshold ratios are excluded from being funded, The threshold varied between 1687 EURO and 6192 EURO. The general reallocation of resources between the three interventions Was a 60% reduction of blood-pressure-lowering drugs with redistribution of resources to advice on smoking cessation and to lipid-lowering drugs. One advantage of this method is that the results are very concrete. Recommendations can thereby he more precise which hopefully will create a public debate between decision-makers, practising phsicians and patient groups.

Ort, förlag, år, upplaga, sidor
Clare: Elsevier, 2006. Vol. 75, nr 2, s. 214-229
Nyckelord [en]
coronary heart disease, randomized controlled trial, cost-effectiveness analysis, hypertensive patients, cholesterol levels, blood pressure, Monica project, risk, pravastatin, stroke
Nationell ämneskategori
Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi
Identifikatorer
URN: urn:nbn:se:umu:diva-14163DOI: 10.1016/j.healthpol.2005.03.008ISI: 000234604900008PubMedID: 16005539OAI: oai:DiVA.org:umu-14163DiVA, id: diva2:153834
Tillgänglig från: 2007-08-28 Skapad: 2007-08-28 Senast uppdaterad: 2018-06-09Bibliografiskt granskad

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Löfroth, EmilLindholm, Lars

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