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Optimising health care within given budgets: primary prevention of cardiovascular disease in different regions of Sweden
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Centre for Epidemiology, National Board of Health and Welfare, SE-106 30, Stockholm, Sweden.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Public Health Sciences.ORCID iD: 0000-0002-1633-2179
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine. Centre for Epidemiology, National Board of Health and Welfare, SE-106 30, Stockholm, 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
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.

Place, publisher, year, edition, pages
Clare: Elsevier, 2006. Vol. 75, no 2, 214-229 p.
Keyword [en]
coronary heart disease, randomized controlled trial, cost-effectiveness analysis, hypertensive patients, cholesterol levels, blood pressure, Monica project, risk, pravastatin, stroke
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
URN: urn:nbn:se:umu:diva-14163DOI: 10.1016/j.healthpol.2005.03.008ISI: 000234604900008PubMedID: 16005539OAI: oai:DiVA.org:umu-14163DiVA: diva2:153834
Available from: 2007-08-28 Created: 2007-08-28 Last updated: 2016-03-02Bibliographically approved

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Löfroth, EmilLindholm, Lars

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