Abstract
Background
Coronary heart disease (CHD) is the highest individual disease burden in Australia and associated with productivity losses through unplanned absence from work, reduced output ...while at work and early labour force withdrawal. Approximately eighty per cent of CHD cases in Australia are preventable, suggesting the potential benefit of employing preventive strategies addressing populations at risk of CHD.
Purpose
To determine the preventable productivity burden attributable to CHD over the next ten years, using the novel productivity measure: the “productivity-adjusted life year” (PALY).
Methods
A dynamic life table model was constructed for the total Australian population, separated by CHD status. Analysis was limited to the Australian working-age population (15–69 years) over ten years (2020–2029). Australian age- and sex-specific prevalence, incidence, migration and mortality data was employed, and productivity estimates were sourced from the literature. The PALY was ascribed a financial value in terms of gross domestic product (GDP) per equivalent full-time worker. The total number of years lived, total PALYs, and total economic burden (in terms of cost of PALYs) were estimated for each year. The model simulation was repeated assuming incidence was reduced, and the differences represented the preventable productivity burden attributable to CHD. All outcomes beyond the first year were discounted by 5% per annum.
Results
Over the next ten years, the total projected years lived and PALYs among the Australian working-age population (with and without CHD) were approximately 132 million and 83 million, respectively, amounting to A$17.2 trillion (€10.5 trillion) in GDP. We predicted nearly 40,000 new (incident) CHD cases over this ten-year period. If, however, we could prevent these new cases of CHD, a total of 14,000 deaths could be averted, resulting in more than 8,000 years of life saved and 100,000 PALYs gained, equivalent to A$21 billion (€12.9 billion) in GDP.
Conclusion
Prevention of CHD will prolong both years of life lived and productive life years, resulting in substantial economic benefit. Policy makers and employers are encouraged to engage in preventive measures addressing CHD.
Funding Acknowledgement
Type of funding source: None
Abstract
Background
The Quality in Acute Stroke Care (QASC) protocol is a multidisciplinary approach to implement evidence-based treatment after acute stroke that reduces death and disability.
Aim
...This study sought to evaluate the cost-effectiveness of implementing the QASC protocol across Australia, from a healthcare and a societal perspective.
Methods
A decision-analytic model was constructed to reflect one-year outcomes post-stroke, aligned with the stroke severity categories of the modified Rankin scale (mRS). Decision analysis compared outcomes following implementation of the QASC protocol versus no implementation. Population data were extracted from Australian databases and data inputs regarding stroke incidence, costs, and utilities were drawn from published sources. The analysis assumed a progressive uptake and efficacy of the QASC protocol over five years. Health benefits and costs were discounted by 5% annually. The cost of each year lived by an Australian, from a societal perspective, was based on the Australian Government's “value of statistical life year” (AUD 213,000).
Results
Over five years, the model predicted 263,722 strokes among the Australian population. The implementation of the QASC protocol was predicted to prevent 1,154 deaths and yield a gain of 876 years of life (0.003 per stroke), and 3,180 quality-adjusted life years (QALYs) (0.012 per stroke). There was an estimated net saving of AUD 65.2 million in healthcare costs (AUD 247 per stroke) and AUD 251.7 million in societal costs (AUD 955 per stroke).
Conclusions
Implementation of the QASC protocol in Australia represents both a dominant (cost-saving) strategy, from a healthcare and a societal perspective.
Funding Acknowledgement
Type of funding sources: None. Decision treePSA
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