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Titolo:
The effect of risk factor reductions between 1981 and 1990 on coronary heart disease incidence, prevalence mortality and cost
Autore:
Goldman, L; Phillips, KA; Coxson, P; Goldman, PA; Williams, L; Hunink, M; Weinstein, MC;
Indirizzi:
Univ Calif San Francisco, Sch Med, Dept Med, San Francisco, CA 94143 USA Univ Calif San Francisco San Francisco CA USA 94143 ancisco, CA 94143 USA Univ Calif San Francisco, Sch Pharm, San Francisco, CA 94143 USA Univ Calif San Francisco San Francisco CA USA 94143 ancisco, CA 94143 USA Univ Calif San Francisco, Inst Hlth Policy Studies, San Francisco, CA 94143 USA Univ Calif San Francisco San Francisco CA USA 94143 ancisco, CA 94143 USA Harvard Sch Publ Hlth, Dept Hlth Policy & Management, Boston, MA USA Harvard Sch Publ Hlth Boston MA USA Policy & Management, Boston, MA USA Brigham & Womens Hosp, Boston, MA 02115 USA Brigham & Womens Hosp Boston MA USA 02115 mens Hosp, Boston, MA 02115 USA Erasmus Univ, Med Ctr, Program Assessment Radiol Technol, Dept Radiol, Rotterdam, Netherlands Erasmus Univ Rotterdam Netherlands Dept Radiol, Rotterdam, Netherlands Erasmus Univ, Med Ctr, Dept Epidemiol & Biostat, Rotterdam, Netherlands Erasmus Univ Rotterdam Netherlands ol & Biostat, Rotterdam, Netherlands
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
fascicolo: 4, volume: 38, anno: 2001,
pagine: 1012 - 1017
SICI:
0735-1097(200110)38:4<1012:TEORFR>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
SMOKING CESSATION; UNITED-STATES; CARDIOVASCULAR MORTALITY; MYOCARDIAL-INFARCTION; CHOLESTEROL LEVELS; EDUCATION-PROGRAM; SECULAR TRENDS; MINNESOTA; CALIFORNIA; PREVENTION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
39
Recensione:
Indirizzi per estratti:
Indirizzo: Goldman, L Univ Calif San Francisco, Sch Med, Dept Med, 505 Parnassus Ave,San Francisco, CA 94143 USA Univ Calif San Francisco 505 Parnassus Ave SanFrancisco CA USA 94143
Citazione:
L. Goldman et al., "The effect of risk factor reductions between 1981 and 1990 on coronary heart disease incidence, prevalence mortality and cost", J AM COL C, 38(4), 2001, pp. 1012-1017

Abstract

OBJECTIVES We sought to estimate the impact and cost-effectiveness of riskfactor reductions between 1981 and 1990. BACKGROUND Coronary heart disease (CHD) mortality rates have declined dramatically, partly as a result of reductions in CHD risk factors. METHODS We used the CHD Policy Model, a validated computer-simulation model, to estimate the effects of actual investments made to change coronary risk factors between 1981 and 1990, as well as the impact of these changes onthe incidence, prevalence, mortality and costs of CHD during this period and projected to 2015. RESULTS Observed changes in risk factors between 1981 and 1990 resulted ina reduction of CHD deaths by similar to 430,000 and overall deaths by similar to 740,000, with an estimated cost-effectiveness of about $44,000 per year of life saved during this period, based on the estimated actual costs of the interventions used. However, because much of the benefit of risk factor reductions is delayed, the estimated reductions for the 35-year period of 1981 to 2015 were 3.6 million CHD deaths and 1.2 million non-CHD deaths, at a cost of only about $5,400 per year of life saved. CONCLUSIONS Aggregate efforts to reduce risk factors between 1981 and 1990have led to substantial reductions in CHD and should be well worth the cost, largely because of population-wide changes in life-style and habits. Some interventions are much better investments than others, and attention to such issues could lead to better use of resources and better outcomes in thefuture. (C) 2001 by the American College of Cardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 23/10/20 alle ore 13:38:29