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Practical issues in the performance and interpretation of costeffectiveness analyses of preventive interventions

Praktijkaspecten bij uitvoering en interpretatie van kosteneffectiviteitsanalyses van preventie

Synopsis

Cost-effective analyses (CEAs) of interventions to prevent health problems are often conducted to investigate whether the effects of a particular intervention offset the costs. In both conducting the CEA and in interpreting the results, it is important to consider the outcomes of the specific intervention were it to be implemented. The National Institute for Public Health and the Environment (RIVM) performed a literature search with the aim to inventorize those practical aspects that may influence the balance between the costs and effects of an intervention. Some of the aspects identified in this survey are the unintentional (positive or negative) side effects of an intervention, insufficient number of professionals to implement an intervention or a lower than expected participation by the target group. This inventory of practical aspects is relevant to researchers conducting CEAs and also to policy-makers, who decide on whether or not to implement an intervention based on the results of CEAs. It should be noted, however, that information on the practical aspects of an intervention is not always available, such as when an intervention has not yet been implemented on a sufficiently large scale. Applying the practical aspects identified in the survey, the RIVM has assessed two interventions: "SchoolGruiten", in which children attending school are stimulated to eat vegetables and fruit, and influenza vaccination for older people. The findings illustrate the extent to which practical information (considered retrospectively) has been included in the CEAs of these specific interventions. The RIVM further recommends conducting CEAs more often on interventions that have already been implemented in order to obtain more practical information that can be included in CEAs.
 

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