Assessing the potential return on investment of the proposed UK NHS diabetes prevention programme in different population subgroups: an economic evaluation

ObjectivesTo evaluate potential return on investment of the National Health Service Diabetes Prevention Programme (NHS DPP) in England and estimate which population subgroups are likely to benefit most in terms of cost-effectiveness, cost-savings and health benefits.DesignEconomic analysis using the School for Public Health Research Diabetes Prevention Model.SettingEngland 2015–2016.PopulationAdults aged ≥16 with high risk of type 2 diabetes (HbA1c 6%–6.4%). Population subgroups defined by age, sex, ethnicity, socioeconomic deprivation, baseline body mass index, baseline HbA1c and working status.InterventionsThe proposed NHS DPP: an intensive lifestyle intervention focusing on dietary advice, physical activity and weight loss. Comparator: no diabetes prevention intervention.Main outcome measuresIncremental costs, savings and return on investment, quality-adjusted life-years (QALYs), diabetes cases, cardiovascular cases and net monetary benefit from an NHS perspective.ResultsIntervention costs will be recouped through NHS savings within 12 years, with net NHS saving of £1.28 over 20 years for each £1 invested. Per 100 000 DPP interventions given, 3552 QALYs are gained. The DPP is most cost-effective and cost-saving in obese individuals, those with baseline HbA1c 6.2%–6.4% and those aged 40–74. QALY gains are lower in minority ethnic and low socioeconomic status subgroups. Probabilistic sensitivity analysis suggests that there is 97% probability that the DPP will be cost-effective within 20 years. NHS savings are highly sensitive to intervention cost, effectiveness and duration of effect.ConclusionsThe DPP is likely to be cost-effective and cost-saving under current assumptions. Prioritising obese individuals could create the most value for money and obtain the greatest health benefits per individual targeted. Low socioeconomic status or ethnic minority groups may gain fewer QALYs per intervention, so targeting strategies should ensure the DPP does not contribute to widening health inequalities. Further evidence is needed around the differential responsiveness of population subgroups to the DPP.

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Cost-Effectiveness of a Community-Based Weight Control Intervention Targeting a Low-Socioeconomic-Status Mexican-Origin Population

Health Promotion Practice ◽

10.1177/1524839914537274 ◽

2014 ◽

Vol 16 (1) ◽

pp. 101-108 ◽

Cited By ~ 9

Author(s):

Kimberly J. Wilson ◽

H. Shelton Brown ◽

Elena Bastida

Keyword(s):

Socioeconomic Status ◽

Cost Effectiveness ◽

Low Socioeconomic Status ◽

Weight Control ◽

Mexican Origin ◽

Community Based ◽

Low Socioeconomic ◽

Control Intervention

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Cost-Effectiveness Analysis of a School-Based Dental Sealant Program for Low-Socioeconomic-Status Children: A Practice-Based Report

CrossRef Listing of Deleted DOIs ◽

10.1177/10492080222148601 ◽

2002 ◽

Vol 13 (1) ◽

pp. 38-48 ◽

Cited By ~ 1

Author(s):

G.P. Zabos ◽

S.A. Glied ◽

J.N. Tobin ◽

E. Amato ◽

L. Turgeon ◽

...

Keyword(s):

Socioeconomic Status ◽

Cost Effectiveness ◽

Low Socioeconomic Status ◽

Cost Effectiveness Analysis ◽

Low Socioeconomic ◽

School Based ◽

Effectiveness Analysis ◽

Dental Sealant

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Clinico-pathological study of liver abscesses with special reference to different treatment options

International Surgery Journal ◽

10.18203/2349-2902.isj20190548 ◽

2019 ◽

Vol 6 (3) ◽

pp. 713

Author(s):

Sailendra Nath Paul ◽

Vijay Kumar Jain

Keyword(s):

Socioeconomic Status ◽

Liver Abscess ◽

Low Socioeconomic Status ◽

Cost Effective ◽

Study Groups ◽

Amoebic Liver Abscess ◽

Percutaneous Catheter Drainage ◽

Disease Etiology ◽

Low Socioeconomic ◽

Liver Abscesses

Background: Liver abscess is a serious life threatening condition if left untreated. Most of them were amoebic in nature in tropical countries. The present study was done with the aim to assess the epidemiology of liver abscesses, to determine the fast, accurate and cost effective diagnostic approaches and to find out the best mode of management for amoebic liver abscess (ALA) and pyogenic liver abscess (PLA) in the study population.Methods: This was a prospective study done at KPC Medical College and Hospital for a period of 2 years, from June 2013 to May 2015. A total of 50 patients diagnosed with liver abscess were included in the study. Patients were categorized into ALA and PLA cases based on the type of abscess cavity. Authors have studied correlation of socio-demographic factors with disease, etiology, diagnostic findings, types of treatment and their outcome in the study population.Results: ALA was the most common type among the study groups (90%). Male preponderance was seen. Majority of them belongs to low-socioeconomic status (80%). The most common etiology of PLA was E. coli. Ultrasonography (USG) of the abdomen was accurate and cost-effective diagnostic procedure for assessing liver abscesses. Percutaneous catheter drainage was the most effective method of treatment (with a 100% success rate) in both ALA and PLA cases.Conclusions: Most of the patients in the study had ALA and had a chronological association with alcohol addiction, diabetes and low-socioeconomic status. Rapid diagnosis of the condition (ALA and PLA) with USG will reduce the rate of morbidity and mortality in the patients.

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Barriers to the Initiation of Home Modifications for Older Adults for Fall Prevention

Geriatric Orthopaedic Surgery & Rehabilitation ◽

10.1177/21514593211002161 ◽

2021 ◽

Vol 12 ◽

pp. 215145932110021

Author(s):

Jessica M. Wiseman ◽

David S. Stamper ◽

Elizabeth Sheridan ◽

Jeffrey M. Caterino ◽

Catherine C. Quatman-Yates ◽

...

Keyword(s):

Older Adults ◽

Socioeconomic Status ◽

Low Socioeconomic Status ◽

Cost Effective ◽

Cross Sectional ◽

Low Socioeconomic ◽

Promising Tool ◽

Home Modifications ◽

Risk Of Falls ◽

Areas Of Interest

Introduction: Home modifications are associated with decreased risk for falls and facilitate safe aging in place. The purpose of this study was to identify barriers to procurement of home modifications for older adults. Materials and Methods: Cross-sectional interviews by 2 separate (1 male and 1 female) researchers in a Midwestern city of home repair (“handyman”) and construction businesses within 15 miles of the areas of interest (neighborhood with a high socioeconomic status and neighborhood with low socioeconomic status) with a publicly listed phone number (n = 98). Estimated cost, earliest date of installation, and duration for a home modification project (installation of 3 grab bars) were collected. Results: At least 1 response was attained only 43% of the time (n = 42), and residential grab bar installations were not provided by most businesses (n = 24). The average quote for materials and labor was $394.31 (range $125-$1300). Five of the 7 businesses that responded to both researchers with the same representative differed in cost estimates, generally offering a reduced quote for the low socioeconomic status neighborhood by as much as $300. Quotes provided to the female researcher were also higher than those obtained by the male researcher by about $30 regardless of socioeconomic status. The average wait for home modifications was 23 days and the average anticipated duration of the project was 2.6 hours. Discussion: There are financial and procedural barriers to accessing home modifications for older adults who independently attempt to acquire them. There is a need for pathways in clinical and community settings to reduce barriers to home modifications to reduce the risk of falls. Conclusion: Home modifications are a promising tool to reduce falls and fall-related injuries in older adults. However, further work to identify cost-effective and timely options to reduce acquisition barriers is necessary to leverage the preventive power of home modifications.

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