期刊
BMC PUBLIC HEALTH
卷 13, 期 -, 页码 -出版社
BMC
DOI: 10.1186/1471-2458-13-953
关键词
Physical activity; Cost effectiveness analysis; Financial incentives; Workplace intervention
资金
- HRB/HSC RAMP
- D/NCI Health Economics Fellowship
- National Prevention 384 Research Initiative (NPRI) [G0802045]
- Alzheimer's 385 Research Trust
- Alzheimer's Society
- Biotechnology and Biological Sciences Research Council
- 386 British Heart Foundation
- Cancer Research UK
- Chief Scientist Office, Scottish Government 387 Health Directorate
- Department of Health
- Diabetes UK
- Economic and Social Research 388 Council
- Engineering and Physical Sciences Research Council
- Health and Social Care Research 389 and Development Division of the Public Health Agency (HSC R D Division)
- Medical 390 Research Council
- The Stroke Association
- Welsh Assembly Government
- World Cancer 391 Research Fund
- Department for Employment and Learning, 392 Northern Ireland [M6003CPH]
- MRC [MR/K023241/1, G0802045] Funding Source: UKRI
- Medical Research Council [MR/K023241/1, G0802045] Funding Source: researchfish
- Public Health Agency [CDV/4259/10] Funding Source: researchfish
Background: Recently both the UK and US governments have advocated the use of financial incentives to encourage healthier lifestyle choices but evidence for the cost-effectiveness of such interventions is lacking. Our aim was to perform a cost-effectiveness analysis (CEA) of a quasi-experimental trial, exploring the use of financial incentives to increase employee physical activity levels, from a healthcare and employer's perspective. Methods: Employees used a `loyalty card' to objectively monitor their physical activity at work over 12 weeks. The Incentive Group (n=199) collected points and received rewards for minutes of physical activity completed. The No Incentive Group (n=207) self-monitored their physical activity only. Quality of life (QOL) and absenteeism were assessed at baseline and 6 months follow-up. QOL scores were also converted into productivity estimates using a validated algorithm. The additional costs of the Incentive Group were divided by the additional quality adjusted life years (QALYs) or productivity gained to calculate incremental cost effectiveness ratios (ICERs). Cost-effectiveness acceptability curves (CEACs) and population expected value of perfect information (EVPI) was used to characterize and value the uncertainty in our estimates. Results: The Incentive Group performed more physical activity over 12 weeks and by 6 months had achieved greater gains in QOL and productivity, although these mean differences were not statistically significant. The ICERs were epsilon 2,900/QALY and epsilon 2,700 per percentage increase in overall employee productivity. Whilst the confidence intervals surrounding these ICERs were wide, CEACs showed a high chance of the intervention being cost-effective at low willingness-to-pay (WTP) thresholds. Conclusions: The Physical Activity Loyalty card (PAL) scheme is potentially cost-effective from both a healthcare and employer's perspective but further research is warranted to reduce uncertainty in our results. It is based on a sustainable business model which should become more cost-effective as it is delivered to more participants and can be adapted to suit other health behaviors and settings. This comes at a time when both UK and US governments are encouraging business involvement in tackling public health challenges.
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