Cost-Effectiveness of Health System and State-Level Strategies to Improve Diet and Reduce Cardiometabolic Diseases

卫生系统的成本效益和改善饮食和减少心血管代谢疾病的国家级战略

基本信息

批准号：
10458609
负责人：
DARIUSH MOZAFFARIAN
金额：
$ 73.67万
依托单位：
TUFTS UNIVERSITY BOSTON
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-08-15 至 2024-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10458609
关键词：
Accountability Address Adopted Advocacy Age Cardiometabolic Disease Chronic Disease Clinical Complex Congresses Data Data Sources Diabetes Mellitus Diet Disincentive Education Electronic Health Record Eligibility Determination Ethnic Origin Farm Federal Government Food Food Policy Future Geographic state Government Grant Health Health Benefit Health Food Health system Healthy Eating Incentives Income Intervention Investigation Legal Measures Media Campaign Medicaid Medical Medicare/Medicaid Medicine Methods Modeling Municipalities Patients Policies Policy Maker Policy Research Population Positioning Attribute Privatization Progress Reports Public Health Quality-Adjusted Life Years Race Research Resources Review Literature Risk Risk Assessment Science Scientist State Government Subgroup Surveys Taxes Testing Time Training Uncertainty Work advocacy organizations authority base comparative cost cost effectiveness disease disparity economic incentive experience experimental study federal policy food insecurity fruits and vegetables health disparity health equity improved incentive program innovation interest method development microcosting nutrition preempt preference programs scale up screening sex sociodemographics success sugar sweetened beverage warning label working group

项目摘要

Project Summary While considerable evidence supports and informs the likely benefits of policy innovations within and outside health systems to improve diet and reduce cardiometabolic diseases (CMD), their impacts on health, disparities, costs, and cost-effectiveness are not well established. Because major diet-related disparities persist, assessing effects of such strategies in at-risk subgroups is crucial. Administrative and legal challenges can strongly influence implementation, scale-up, and sustainability of such strategies, but such considerations have not yet been rigorously assessed. Our specific aims extend our prior analyses of national policies to address crucial questions for health system strategies and state-specific actions and to disseminate this evidence. The aims are 1) to estimate the health impacts, costs, cost-effectiveness, and effects on disparities of specific health system strategies to improve diet and reduce CMD in the US; 2) to estimate the health impacts, costs, cost-effectiveness, and effects on disparities of specific state-level policies to improve diet and reduce CMD in the US; 3) to assess the administrative and legal challenges and feasibility of specific health system and state strategies to improve diet and reduce CMD in the US; and 4) to disseminate our top findings from the prior period, related grants, and this new work to relevant stakeholders in key legislative, agency, and advocacy positions. Building on our prior experience, we will evaluate health system interventions, state interventions, and administrative/legal feasibility. We will define plausible policy effect sizes and their uncertainty based on reviews of literature and expert contacts; and adopt a micro-costing approach using established methods to assess policy costs including by sectors. We will project costs and CMD benefits of each policy, using established modeling approaches, and quantify comparative efficiency measured by ICER comparing each intervention to a base case. Effects on disparities will be evaluated comparing differences in CMD disparities (difference in difference approach) for each action in key population subgroups. We will conduct in-depth administrative and legal analysis to identify the likely conditions for success and the authorities and obstacles for implementation.

项目摘要尽管有大量证据支持并告知内部和外部政策创新的可能好处改善饮食和减少心脏代谢疾病（CMD）的卫生系统，它们对健康的影响，差异，成本和成本效益尚未确定。因为主要的饮食相关差异持续存在，评估此类策略在高风险亚组中的影响至关重要。行政和法律挑战可以强烈影响此类策略的实施，扩展和可持续性，但是这些考虑因素尚未经过严格评估。我们的具体目标将我们先前对国家政策的分析扩展到解决卫生系统策略和特定国家的行动的关键问题，并将其传播证据。目的是1）估计健康影响，成本，成本效益和对差异的影响在美国改善饮食和减少CMD的特定卫生系统策略； 2）估计健康影响，成本，成本效益以及对特定州级政策差异的影响，以改善饮食和减少美国的CMD； 3）评估特定健康的行政和法律挑战和可行性在美国改善饮食和减少CMD的系统和国家策略； 4）传播我们的最佳发现从上一时期开始，相关赠款和这项新工作向关键立法，机构和倡导职位。在我们先前的经验的基础上，我们将评估卫生系统干预措施，州干预措施以及行政/法律可行性。我们将定义合理的政策效应规模及其基于文学和专家联系的评论的不确定性；并采用一种微观的方法建立的方法来评估包括部门在内的政策成本。我们将预测成本和CMD的好处每种政策，使用既定的建模方法，并量化ICER衡量的比较效率将每个干预与基本情况进行比较。将评估对差异的影响，以比较关键人群亚组中每个动作的CMD差异（差异方法差异）。我们将进行深入的行政和法律分析，以确定成功的可能条件和当局和实施障碍。