Taking a local government perspective for economic evaluation of a population-level programme to promote exercise |
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| Authors: | Paolo Candio David Meads Andrew J. Hill Laura Bojke |
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| Affiliation: | 1. Pharmacotherapy Outcomes Research Center, College of Pharmacy, University of Utah, 30 S 2000 E, Salt Lake City, 84112, UT, USA;2. Population Informatics Lab, Texas A&M University, 212 Adriance Lab Rd, College Station, 77843, TX, USA;3. Laboratory of Health Economics & Management, Economics Department, University of Piraeus, Karaoli ke Dimitriou 80, 185 34, Piraeus, Greece;4. Department of Health Policy & Management, School of Public Health, Texas A&M University, 212 Adriance Lab Rd, 77843, College Station, TX, USA;5. University Regional General Hospital of Patras, University of Patras, 26504, Patras, Rion, Greece;6. Department of Social and Education Policy, University of Peloponnese, Damaskinou & Kolokotroni Str., 20100, Corinth, Greece;1. VIVE – The Danish Center for Social Science Research, Herluf Trolles Gade 11, København K, DK;2. Centre for Health Policy, Institute of Global Health Innovation, Imperial College London, SW7 2A London, UK;3. Danish Centre for Health Economics, University of Southern Denmark, J.B. Winsløws Vej 9B, Odense C, DK;4. Department of Business and Economics, University of Southern Denmark, Campusvej 55, 5230 Odense M, DK |
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| Abstract: | ![]()
BackgroundIn order to tackle the issue of physical inactivity, local governments have implemented population-level programmes to promote exercise. While evidence is accumulating on the cost-effectiveness of these interventions, studies have typically adopted a health sector perspective for economic evaluation. This approach has been challenged as it does not allow for key concerns by local governments, which are primary stakeholders, to be addressed.ObjectivesTo show how taking a local government perspective for economic evaluation can be implemented in practice and this may affect the economic conclusions.MethodsBased on data from a case study, the health equity impact of the intervention and its opportunity cost from a service provider viewpoint were assessed. The cost-effectiveness implications of a change in perspective were subsequently estimated by means of scenario analysis.FindingsThe intervention was found to provide adult residents living in the most deprived city areas with greater health benefits compared with the rest of the population. However, a negative net equity impact was found in the short-term. The opportunity cost of the intervention was estimated to be substantially lower than its financial cost (£2.77 per person/year), with significant implications for decision-making.ConclusionsTaking a local government perspective can affect the conclusions drawn from the economic evaluation of population-level programmes to promote exercise, and therefore influence decision making. |
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| Keywords: | Health equity Opportunity cost Local government Perspective Cost-effectiveness |
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