Optimising health care within given budgets: primary prevention of cardiovascular disease in different regions of Sweden
2006 (English)In: Health Policy, ISSN 0168-8510, E-ISSN 1872-6054, Vol. 75, no 2, 214-229 p.Article in journal (Refereed) Published
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.
Place, publisher, year, edition, pages
Clare: Elsevier, 2006. Vol. 75, no 2, 214-229 p.
coronary heart disease, randomized controlled trial, cost-effectiveness analysis, hypertensive patients, cholesterol levels, blood pressure, Monica project, risk, pravastatin, stroke
Health Care Service and Management, Health Policy and Services and Health Economy
IdentifiersURN: urn:nbn:se:umu:diva-14163DOI: 10.1016/j.healthpol.2005.03.008ISI: 000234604900008PubMedID: 16005539OAI: oai:DiVA.org:umu-14163DiVA: diva2:153834