Measuring the costs and benefits of heart disease monitoring

A Perry, S Capewell, A Walker, J Chalmers, A Redpath, K Major, C E Morrison, N Craig, S Cobbe, W C S Smith

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective-To evaluate the costs and benefits of alternative systems of coronary heart disease monitoring in Scotland.

Design-An option appraisal was conducted to evaluate the costs and benefits of implementing a coronary heart disease monitoring system. This involved a review of existing Scottish datasets and relevant reports, specification of options, definition and weighting of benefit criteria by key stakeholders, assessment of options by experts, and costing of options. The options were assessed by 33 stakeholders (grouped as cardiologists, patient representatives, general practitioners, public health physicians, and policy makers), plus 13 topic experts.

Setting-Scotland (population 5.1 million).

Results-Between group mean benefit weights were: mortality rates and case fatality (10.6), quality of life (9.8), patient function (8.8), hospital activity (7.8), primary care activity (9.25), prescribing (5.72), socioeconomic impact (4.0), risk factors (7.4), prevalence (5.0), incidence (6.0), case registration (6.82), international comparability (4.2), breadth of coverage (8.8), and frequency (5.8). Differences between group weights were significant for prevalence (p = 0.048) and international comparability (p = 0.032). Four monitoring options were identified: a community epidemiology, model, based on MONICA (monitoring trends and determinants in cardiovascular disease) study methodology applied to a series of eight representative communities, had the highest benefits, at an average annual discounted cost of approximately pound 360 000; models based on the Australian cardiovascular disease monitoring scheme and on enhanced routine data offered fewer benefits at discounted average annual costs ranging from pound 165 000 to pound 195 000; finally, a coronary heart disease registry modelled on the Scottish Cancer Registry scheme would have had fewer benefits and substantially higher costs than the other options.

Conclusions-The most beneficial coronary heart disease monitoring system is the community epidemiology model, based on MONICA methodology. Option appraisal potentially offers an explicit and transparent methodology for evidence based policy development.

Original languageEnglish
Pages (from-to)651-656
Number of pages6
JournalHeart
Volume83
Publication statusPublished - 2000

Keywords

  • monitoring
  • surveillance
  • heart disease
  • option appraisal
  • DESIGN

Cite this

Perry, A., Capewell, S., Walker, A., Chalmers, J., Redpath, A., Major, K., ... Smith, W. C. S. (2000). Measuring the costs and benefits of heart disease monitoring. Heart, 83, 651-656.

Measuring the costs and benefits of heart disease monitoring. / Perry, A ; Capewell, S ; Walker, A ; Chalmers, J ; Redpath, A ; Major, K ; Morrison, C E ; Craig, N ; Cobbe, S ; Smith, W C S .

In: Heart, Vol. 83, 2000, p. 651-656.

Research output: Contribution to journalArticle

Perry, A, Capewell, S, Walker, A, Chalmers, J, Redpath, A, Major, K, Morrison, CE, Craig, N, Cobbe, S & Smith, WCS 2000, 'Measuring the costs and benefits of heart disease monitoring' Heart, vol. 83, pp. 651-656.
Perry A, Capewell S, Walker A, Chalmers J, Redpath A, Major K et al. Measuring the costs and benefits of heart disease monitoring. Heart. 2000;83:651-656.
Perry, A ; Capewell, S ; Walker, A ; Chalmers, J ; Redpath, A ; Major, K ; Morrison, C E ; Craig, N ; Cobbe, S ; Smith, W C S . / Measuring the costs and benefits of heart disease monitoring. In: Heart. 2000 ; Vol. 83. pp. 651-656.
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abstract = "Objective-To evaluate the costs and benefits of alternative systems of coronary heart disease monitoring in Scotland.Design-An option appraisal was conducted to evaluate the costs and benefits of implementing a coronary heart disease monitoring system. This involved a review of existing Scottish datasets and relevant reports, specification of options, definition and weighting of benefit criteria by key stakeholders, assessment of options by experts, and costing of options. The options were assessed by 33 stakeholders (grouped as cardiologists, patient representatives, general practitioners, public health physicians, and policy makers), plus 13 topic experts.Setting-Scotland (population 5.1 million).Results-Between group mean benefit weights were: mortality rates and case fatality (10.6), quality of life (9.8), patient function (8.8), hospital activity (7.8), primary care activity (9.25), prescribing (5.72), socioeconomic impact (4.0), risk factors (7.4), prevalence (5.0), incidence (6.0), case registration (6.82), international comparability (4.2), breadth of coverage (8.8), and frequency (5.8). Differences between group weights were significant for prevalence (p = 0.048) and international comparability (p = 0.032). Four monitoring options were identified: a community epidemiology, model, based on MONICA (monitoring trends and determinants in cardiovascular disease) study methodology applied to a series of eight representative communities, had the highest benefits, at an average annual discounted cost of approximately pound 360 000; models based on the Australian cardiovascular disease monitoring scheme and on enhanced routine data offered fewer benefits at discounted average annual costs ranging from pound 165 000 to pound 195 000; finally, a coronary heart disease registry modelled on the Scottish Cancer Registry scheme would have had fewer benefits and substantially higher costs than the other options.Conclusions-The most beneficial coronary heart disease monitoring system is the community epidemiology model, based on MONICA methodology. Option appraisal potentially offers an explicit and transparent methodology for evidence based policy development.",
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TY - JOUR

T1 - Measuring the costs and benefits of heart disease monitoring

AU - Perry, A

AU - Capewell, S

AU - Walker, A

AU - Chalmers, J

AU - Redpath, A

AU - Major, K

AU - Morrison, C E

AU - Craig, N

AU - Cobbe, S

AU - Smith, W C S

PY - 2000

Y1 - 2000

N2 - Objective-To evaluate the costs and benefits of alternative systems of coronary heart disease monitoring in Scotland.Design-An option appraisal was conducted to evaluate the costs and benefits of implementing a coronary heart disease monitoring system. This involved a review of existing Scottish datasets and relevant reports, specification of options, definition and weighting of benefit criteria by key stakeholders, assessment of options by experts, and costing of options. The options were assessed by 33 stakeholders (grouped as cardiologists, patient representatives, general practitioners, public health physicians, and policy makers), plus 13 topic experts.Setting-Scotland (population 5.1 million).Results-Between group mean benefit weights were: mortality rates and case fatality (10.6), quality of life (9.8), patient function (8.8), hospital activity (7.8), primary care activity (9.25), prescribing (5.72), socioeconomic impact (4.0), risk factors (7.4), prevalence (5.0), incidence (6.0), case registration (6.82), international comparability (4.2), breadth of coverage (8.8), and frequency (5.8). Differences between group weights were significant for prevalence (p = 0.048) and international comparability (p = 0.032). Four monitoring options were identified: a community epidemiology, model, based on MONICA (monitoring trends and determinants in cardiovascular disease) study methodology applied to a series of eight representative communities, had the highest benefits, at an average annual discounted cost of approximately pound 360 000; models based on the Australian cardiovascular disease monitoring scheme and on enhanced routine data offered fewer benefits at discounted average annual costs ranging from pound 165 000 to pound 195 000; finally, a coronary heart disease registry modelled on the Scottish Cancer Registry scheme would have had fewer benefits and substantially higher costs than the other options.Conclusions-The most beneficial coronary heart disease monitoring system is the community epidemiology model, based on MONICA methodology. Option appraisal potentially offers an explicit and transparent methodology for evidence based policy development.

AB - Objective-To evaluate the costs and benefits of alternative systems of coronary heart disease monitoring in Scotland.Design-An option appraisal was conducted to evaluate the costs and benefits of implementing a coronary heart disease monitoring system. This involved a review of existing Scottish datasets and relevant reports, specification of options, definition and weighting of benefit criteria by key stakeholders, assessment of options by experts, and costing of options. The options were assessed by 33 stakeholders (grouped as cardiologists, patient representatives, general practitioners, public health physicians, and policy makers), plus 13 topic experts.Setting-Scotland (population 5.1 million).Results-Between group mean benefit weights were: mortality rates and case fatality (10.6), quality of life (9.8), patient function (8.8), hospital activity (7.8), primary care activity (9.25), prescribing (5.72), socioeconomic impact (4.0), risk factors (7.4), prevalence (5.0), incidence (6.0), case registration (6.82), international comparability (4.2), breadth of coverage (8.8), and frequency (5.8). Differences between group weights were significant for prevalence (p = 0.048) and international comparability (p = 0.032). Four monitoring options were identified: a community epidemiology, model, based on MONICA (monitoring trends and determinants in cardiovascular disease) study methodology applied to a series of eight representative communities, had the highest benefits, at an average annual discounted cost of approximately pound 360 000; models based on the Australian cardiovascular disease monitoring scheme and on enhanced routine data offered fewer benefits at discounted average annual costs ranging from pound 165 000 to pound 195 000; finally, a coronary heart disease registry modelled on the Scottish Cancer Registry scheme would have had fewer benefits and substantially higher costs than the other options.Conclusions-The most beneficial coronary heart disease monitoring system is the community epidemiology model, based on MONICA methodology. Option appraisal potentially offers an explicit and transparent methodology for evidence based policy development.

KW - monitoring

KW - surveillance

KW - heart disease

KW - option appraisal

KW - DESIGN

M3 - Article

VL - 83

SP - 651

EP - 656

JO - Heart

JF - Heart

SN - 1355-6037

ER -