背景:此分析的目的是快速评估潜在成本,成本效益,以及多部门社区伙伴关系(MCP)通过解决健康的社会决定因素(SDOH)改善慢性病结局和促进健康公平的努力的长期影响。
方法:2022年,评估人员与13个MCP合作,收集有关实施SDOH干预措施的启动和持续成本以及干预范围和时机的数据。2023年,该团队使用预防影响模拟模型(PRISM)来估计MCP努力超过5,10-,和20年的时期。该团队还分析了MCPs\'SDOH干预措施的成本和累计10年和20年的成本效益。
结果:超过20年,由13个MCP实施的SDOH干预措施可以预防970例过早死亡,避免1.05亿美元的医疗费用和4.08亿美元的生产力损失。20年的累积结果显示,从医疗保健部门的角度来看,每质量调整生命年的潜在净成本为38300美元,并表明从社会角度来看,潜在的成本降低和健康结果改善。
结论:这些发现有助于为未来SDOH干预措施的投资提供信息和支持。通过更好地了解启动和实施SDOH干预措施所需的成本,资助者和MCP可以为完成这项工作所需的资源做好准备。研究结果还表明,大多数MCP实施的SDOH干预措施具有良好的长期影响和潜在的成本效益。
BACKGROUND: The purpose of this analysis was to rapidly evaluate the potential costs, cost-effectiveness, and long-term effects of efforts by multisector community partnerships (MCPs) to improve chronic disease outcomes and advance health equity by addressing social determinants of health (SDOH).
METHODS: In 2022, the evaluators partnered with 13 MCPs to collect data on start-up and ongoing costs for implementing SDOH interventions and on intervention reach and timing. In 2023, the team used the Prevention Impacts Simulation Model to estimate the longer-term impact of MCPs\' efforts over 5-, 10-, and 20-year periods. The team also analyzed costs and cumulative 10- and 20-year cost-effectiveness of the MCPs\' SDOH interventions.
RESULTS: Over 20 years, SDOH interventions implemented by the 13 MCPs can potentially prevent 970 premature deaths and avert $105 million in medical costs and $408 million in productivity losses. The 20-year cumulative results show potential net costs of $38,300 per quality-adjusted life-year gained from the healthcare sector perspective and indicate potentially reduced costs and improved health outcomes from the societal perspective.
CONCLUSIONS: These findings can help inform and provide support for future investments in SDOH interventions. With a better understanding of costs needed to start up and implement SDOH interventions, funders, and MCPs can prepare for the resources required to do this work. Findings also suggest promising long-term impacts and potential cost-effectiveness for most MCP-implemented SDOH interventions.