Gesundheitsökonomische Evaluation der Gesundheitsförderung – am Beispiel „fit für pisa“

Abstract

The increasing prevalence of risk factors associated with physical inactivity lead to an economic burden on society. The article uses the example of the prevention measure "fit for pisa" to investigate to what extent a full economic evaluation can provide a basis for decision-makers. The intervention integrated the daily physical education at 5 primary schools in Göttingen for the entire school term. The study is intended to provide information on short- and long-term potential savings. A process analysis identified the prevention performance from a societal perspective. Resource consumption was recorded in (partly) standardisedform and evaluated and also revealed the need for investment in sports halls with capacity to expand the programme to all primary schools in Göttingen. In the routine the implementation costs of half-day schools are 619 € per student year; for all-day schools 236 € per student year. The consideration of the short-term outcomes shows that TV viewing has decreased and physical activity has been strongly encouraged. The active life style promotion has shown an improvement on BMI in the medium-term. On the basis of a decision analytical model, a cost-benefit analysis of the program over the life course will be undertaken.

Potential Transferability of Economic Evaluations of Programs Encouraging Physical Activity in Children and Adolescents across Different Countries—A Systematic Review of the Literature

“…In total, 13 studies were found that fulfilled the inclusion criteria. Twelve different interventions aiming to increase physical activity in children and adolescents (and to some extent better nutrition and a healthier lifestyle in general) were analyzed focusing on the prevention of overweight and obesity [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ]. One of the interventions was also examined with regard to the prevention of disordered weight control behaviors (DWCB) [ 29 ].…”

“…Eight of the publications cited the primary prevention of overweight as being the major aim of the intervention [ 17 , 18 , 19 , 20 , 21 , 23 , 24 , 27 , 28 ], two publications focused on exercise promotion in general [ 25 , 26 ], and the last publication reported the primary prevention of DWCB as the major aim of the intervention [ 29 ]. It is interesting to note that this last study [ 29 ] was based on the same program (Planet Health) as the study of Wang et al , 2003 [ 28 ], with one of them examining the prevention of overweight and the other the prevention of DWCB.…”

“…Most of the interventions took place in a school setting (seven interventions) [ 17 , 21 , 23 , 24 , 27 , 28 , 29 ], but one of them was in a community setting [ 26 ], and four had a combination of a school and a community setting [ 18 , 19 , 20 , 22 ], whereas the final intervention was designed for society [ 25 ].…”

“…When looking at the study design, five studies analyzed the economic aspects of the intervention programs [ 17 , 22 , 23 , 25 , 27 ] with cost-effectiveness analyses [ 17 , 22 , 23 , 25 , 27 ], and eight studies used a model approach [ 18 , 19 , 20 , 21 , 24 , 26 , 28 , 29 ]. Of the studies that have a model approach, five performed cost-utility analyses [ 18 , 19 , 20 , 21 , 26 ], and three performed cost-effectiveness analyses and additionally reported the net benefit of the intervention [ 24 , 28 , 29 ].…”

“…The second modeling study by Wang et al , (2011) [ 29 ] also used 3% for discounting, but a time horizon of only 10 years. The four remaining studies are intervention studies, two of them with a time horizon of 1 year and therefore without discounting costs and effects [ 23 , 27 ], one with a time horizon of 4 years and a discount rate of 5% for the costs [ 22 ], and one reported details of neither the time horizon nor the discounting rate [ 17 ].…”