| Title | Cost and cost-effectiveness of a school-based education program to reduce salt intake in children and their families in China |
| Authors | Li, Xian Jan, Stephen Yan, Lijing L. Hayes, Alison Chu, Yunbo Wang, Haijun Feng, Xiangxian Niu, Wenyi He, Feng J. Ma, Jun Han, Yanbo MacGregor, Graham A. Wu, Yangfeng |
| Affiliation | Peking Univ, Hlth Sci Ctr, George Inst Global Hlth, Beijing, Peoples R China. George Inst Global Hlth, Sydney, NSW, Australia. Univ Sydney, Sch Publ Hlth, Sydney, NSW, Australia. Peking Univ, Hlth Sci Ctr, Inst Child & Adolescent Hlth, Beijing, Peoples R China. Changzhi Med Coll, Changzhi, Shanxi, Peoples R China. Queen Mary Univ London, Barts & London Sch Med & Dent, Wolfson Inst Prevent Med, London, England. Peking Univ, Sch Publ Hlth, Dept Epidemiol & Biostat, Beijing, Peoples R China. Peking Univ, Clin Res Inst, Beijing, Peoples R China. Duke Kunshan Univ, Global Hlth Res Ctr, Kunshan, Jiangsu, Peoples R China. Peking Univ, Hlth Sci Ctr, George Inst Global Hlth, Beijing, Peoples R China. Wu, YF (reprint author), Peking Univ, Sch Publ Hlth, Dept Epidemiol & Biostat, Beijing, Peoples R China. Wu, YF (reprint author), Peking Univ, Clin Res Inst, Beijing, Peoples R China. |
| Keywords | CARDIOVASCULAR-DISEASE RISK BLOOD-PRESSURE SODIUM-INTAKE DIETARY-SODIUM HYPERTENSION POPULATION STROKE INTERVENTIONS STRATEGIES INFARCTION |
| Issue Date | 2017 |
| Publisher | PLOS ONE |
| Citation | PLOS ONE.2017,12(9). |
| Abstract | Objective The School-based Education Program to Reduce Salt Intake in Children and Their Families study was a cluster randomized control trial among grade five students in 28 primary schools and their families in Changzhi, China. It achieved a significant effect in lowering systolic blood pressure (SBP) in all family adults by 2.3 mmHg and in elderlies (aged > = 60 years) by 9.5 mmHg. The aim of this study was to assess the cost-effectiveness of this salt reduction program. Methods Costs of the intervention were assessed using an ingredients approach to identify resource use. A trial-based incremental cost-effectiveness ratio (ICER) was estimated based on the observed effectiveness in lowering SBP. A Markov model was used to estimate the long-term cost-effectiveness of the intervention, and then based on population data, extrapolated to a scenario where the program is scaled up nationwide. Findings were presented in terms of an incremental cost per quality-adjusted life year (QALY). The perspective was that of the health sector. Results The intervention cost Int$19.04 per family and yielded an ICER of Int$2.74 (90% CI: 1.17-12.30) per mmHg reduction of SBP in all participants (combining children and adult participants together) compared with control group. If scaled up nationwide for 10 years and assumed deterioration in treatment effect of 50% over this period, it would reach 165 million families and estimated to avert 42,720 acute myocardial infarction deaths and 107,512 stroke deaths in China. This would represent a gain of 635,816 QALYs over 10-year time frame, translating into Int$1,358 per QALY gained. Conclusion Based on WHO-CHOICE criteria, our analysis demonstrated that the proposed salt reduction strategy is highly cost-effective, and if scaled up nationwide, the benefits could be substantial. |
| URI | http://hdl.handle.net/20.500.11897/468962 |
| ISSN | 1932-6203 |
| DOI | 10.1371/journal.pone.0183033 |
| Indexed | SCI(E) SSCI |
| Appears in Collections: | 公共卫生学院 |
