Gesundheitswesen 2024; 86(S 05): S321-S322
DOI: 10.1055/s-0044-1794326
Abstracts │ ÖGPH

Assessing long-term health outcomes and cost effectiveness of a community-based intervention to prevent obesity in Austria – development of a decision-analytic model

Julia Santamaria
1   Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT TIROL – University for Health Sciences and Technology, Hall in Tirol, Austria
,
Beate Jahn
1   Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT TIROL – University for Health Sciences and Technology, Hall in Tirol, Austria
,
Daniela Schmid-Gallmetzer
2   Division for Quantitative Methods in Public Health and Health Services Research, Institute of Public Health, Medical Decision Making and Health Technology Assessment; Department of Public Health, Health Services Research and Health Technology Assessment; UMIT TIROL – University for Health Sciences and Technology, Hall i.T., Austria
,
Kieran Tuohy
3   Nutrition and Nutrigenomics Unit; Research and Innovation Center – Fondazione Edmund March, S. Michele all’Adige, Italy
4   School of Food Science & Nutrition, University of Leeds, United Kingdom
,
Michael Laxy
5   Professorship of Public Health and Prevention, School of Medicine and Health, Technical University of Munich, Germany
,
Uwe Siebert
1   Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT TIROL – University for Health Sciences and Technology, Hall in Tirol, Austria
6   Institute for Technology Assessment and Department of Radiology; Massachusetts General Hospital; Harvard Medical School, Boston, MA, USA
7   Division of Health Technology Assessment and Bioinformatics; ONCOTYROL – Center for Personalized Cancer Medicine, Innsbruck, Austria
8   Center for Health Decision Science; Departments of Epidemiology and Health Policy & Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA
,
Nikolai Mühlberger
1   Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT TIROL – University for Health Sciences and Technology, Hall in Tirol, Austria
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Background The prevalence of overweight and obesity among adults (>15 years of age) has increased up to more than 50% in Austria and worldwide. Our previous systematic review on the effectiveness of community-based interventions (CBIs) to prevent obesity, identified programs demonstrating a body mass index (BMI) reduction, but the long-term effects in terms of health outcomes and costs in an Austrian setting have not been yet evaluated. Therefore, our study, funded by the EUREGIO-Environment, Food, Health Project, aims to develop a decision-analytic model (DAM) to assess the benefits, harms, costs and cost effectiveness of a CBI in Austria.

Methods To evaluate a CBI in comparison to no intervention in terms of long-term health outcomes, costs and cost-effectiveness for an adolescent Austrian cohort, we developed a framework and DAM for obesity. We also performed a review to select obesity-related diseases for inclusion in the model.

Results We chose a Markov model to run an Austrian cohort that starts at a free-of-events health state with three different weight categories (normal weight, overweight, obese). Over time, individuals can develop stroke, type 2 Diabetes mellitus, colorectal cancer and coronary heart disease, or die. The diseases included were based on the review findings. We chose quality-adjusted life years, life years and deaths as health outcomes, costs from a societal perspective as the economic impact and the incremental cost-effectiveness ratio for cost effectiveness. An intervention (“Shape Up Somerville”) showing a BMI reduction was identified in the systematic review and its effects were applied as a shift in the weight distribution at the starting cohort. For the transition probabilities, we used age-dependent prevalences, relative risks, incidence rates, mortality rates, utilities, and costs from Austrian studies when available, otherwise the most comparable international data were applied. Scenario analyses for different intervention effect assumptions and sensitivity analyses for various parameters were also defined.



Publication History

Article published online:
05 December 2024

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