Modelling the cost-effectiveness of alcohol screening and brief interventions in primary care in England.
Alcohol Alcohol
; 48(2): 180-8, 2013.
Article
em En
| MEDLINE
| ID: mdl-23015608
ABSTRACT
AIMS:
To estimate the cost-effectiveness and resourcing implications of universal alcohol screening and brief intervention (SBI) programmes in primary care in England.METHODS:
This was a health economic model, combining evidence of the effectiveness and health care resource requirements of SBI activities with existing epidemiological modelling of the relationship between alcohol consumption and health harms.RESULTS:
Screening patients on registration with a family doctor would steadily capture ~40% of the population over a 10-year programme; screening patients at next primary care consultation would capture 96% of the population over the same period, but with high resourcing needs in the first year. The registration approach, delivered by a practice nurse, provides modest cost savings to the health care system of £120 m over 30 years. Health gains over the same period amount to 32,000 quality-adjusted life years (QALYs). This SBI programme still appears cost-effective (at £6900 per QALY gained) compared with no programme, under pessimistic effectiveness assumptions. Switching to a consultation approach, delivered by a doctor, would incur an incremental net cost of £108 m, with incremental health gains equivalent to 92,000 QALYs, giving an incremental cost-effectiveness ratio of £1175 per QALY gained compared with current practice.CONCLUSION:
A universal programme of alcohol SBI in primary care is estimated to be cost-effective, under all but the most pessimistic assumptions for programme costs and effectiveness. Policymakers should ensure that SBI programmes are routinely evaluated and followed up, given the substantial uncertainty over the effects of many of the implementation details.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Atenção Primária à Saúde
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Consumo de Bebidas Alcoólicas
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Programas de Rastreamento
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Modelos Econômicos
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Intervenção Médica Precoce
Tipo de estudo:
Clinical_trials
/
Diagnostic_studies
/
Health_economic_evaluation
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Prognostic_studies
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Screening_studies
Limite:
Adolescent
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Adult
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Aged
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Alcohol Alcohol
Ano de publicação:
2013
Tipo de documento:
Article
País de afiliação:
Reino Unido