Résumé
Objective : To develop a model to assess the long-term costs and health outcomes of physical activity interventions targeting adolescents.
Design : A Markov cohort simulation model was constructed with the intention of being capable of estimating long-term costs and health impacts of changes in activity levels during adolescence. The model parameters were informed by published literature and the analysis took a National Health Service perspective over a lifetime horizon. Univariate and probabilistic sensitivity analyses were undertaken.
Setting : School and community.
Participants : A hypothetical cohort of adolescents aged 16 years at baseline.
Interventions : Two exemplar school-based: a comparatively simple, after-school intervention and a more complex multicomponent intervention compared with usual care.
Primary and secondary outcome measures : Incremental cost-effectiveness ratio as measured by cost per quality-adjusted life year gained.
Results : The model gave plausible estimates of the long-term effect of changes in physical activity. The use of two exemplar interventions suggests that the model could potentially be used to evaluate a number of different physical activity interventions in adolescents. The key model driver was the degree to which intervention effects were maintained over time.
Conclusions : The model developed here has the potential to assess long-term value for money of physical activity interventions in adolescents. The two applications of the model indicate that complex interventions may not necessarily be the ones considered the most cost-effective when longer-term costs and consequences are taken into account.
Design : A Markov cohort simulation model was constructed with the intention of being capable of estimating long-term costs and health impacts of changes in activity levels during adolescence. The model parameters were informed by published literature and the analysis took a National Health Service perspective over a lifetime horizon. Univariate and probabilistic sensitivity analyses were undertaken.
Setting : School and community.
Participants : A hypothetical cohort of adolescents aged 16 years at baseline.
Interventions : Two exemplar school-based: a comparatively simple, after-school intervention and a more complex multicomponent intervention compared with usual care.
Primary and secondary outcome measures : Incremental cost-effectiveness ratio as measured by cost per quality-adjusted life year gained.
Results : The model gave plausible estimates of the long-term effect of changes in physical activity. The use of two exemplar interventions suggests that the model could potentially be used to evaluate a number of different physical activity interventions in adolescents. The key model driver was the degree to which intervention effects were maintained over time.
Conclusions : The model developed here has the potential to assess long-term value for money of physical activity interventions in adolescents. The two applications of the model indicate that complex interventions may not necessarily be the ones considered the most cost-effective when longer-term costs and consequences are taken into account.
langue originale | Anglais |
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journal | BMJ Open |
Volume | 9 |
Numéro de publication | 8 |
Les DOIs | |
état | Publié - 18 août 2019 |
mots-clés
- Physical activity
- long-term costs
- health outcomes of physical activity
- Adolescents