Dataset Information

The economic benefits of reducing cardiovascular disease mortality in Quebec, Canada.

ABSTRACT: We assess how different scenarios of cardiovascular disease (CVD) prevention, aimed at meeting targets set by the World Health Organization (WHO) for 2025), may impact healthcare spending in Quebec, Canada over the 2050 horizon.We provide long-term forecasts of healthcare use and costs at the Quebec population level using a novel dynamic microsimulation model. Using both survey and administrative data, we simulate the evolution of the Quebec population's health status until death, through a series of dynamic transitions that accounts for social and demographic characteristics associated with CVD risk factors.A 25% reduction in CVD mortality between 2012 and 2025 achieved through decreased incidence could contain the pace of healthcare cost growth towards 2050 by nearly 7 percentage points for consultations with a physician, and by almost 9 percentage points for hospitalizations. Over the 2012-2050 period, the present value of cost savings is projected to amount to C$13.1 billion in 2012 dollars. The years of life saved due to improved life expectancy could be worth another C$38.2 billion. Addressing CVD mortality directly instead would bring about higher healthcare costs, but would generate more value in terms of years of life saved, at C$69.6 billion.Potential savings associated with plausible reductions in CVD, aimed at reaching a World Health Organization target over a 12-year period, are sizeable and may help address challenges associated with an aging population.

SUBMITTER: Boisclair D

PROVIDER: S-EPMC5754059 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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The economic benefits of reducing cardiovascular disease mortality in Quebec, Canada.

Boisclair David D Décarie Yann Y Laliberté-Auger François F Michaud Pierre-Carl PC Vincent Carole C

PloS one 20180104 1

<h4>Objectives</h4>We assess how different scenarios of cardiovascular disease (CVD) prevention, aimed at meeting targets set by the World Health Organization (WHO) for 2025), may impact healthcare spending in Quebec, Canada over the 2050 horizon.<h4>Methods</h4>We provide long-term forecasts of healthcare use and costs at the Quebec population level using a novel dynamic microsimulation model. Using both survey and administrative data, we simulate the evolution of the Quebec population's health ...[more]

PMID: 29300783

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Project description:ObjectiveTo examine the potential effect of a tax on palm oil on hyperlipidemia and on mortality due to cardiovascular disease in India.DesignEconomic-epidemiologic model.Modeling methodsA microsimulation model of mortality due to myocardial infarction and stroke among Indian populations was constructed, incorporating nationally representative data on systolic blood pressure, total cholesterol, tobacco smoking, diabetes, and cardiovascular event history, and stratified by age, sex, and urban/rural residence. Household expenditure data were used to estimate the change in consumption of palm oil following changes in oil price and the potential substitution of alternative oils that might occur after imposition of a tax. A 20% excise tax on palm oil purchases was simulated over the period 2014-23.Main outcome measuresThe model was used to project future mortality due to myocardial infarction and stroke, as well as the potential effect of a tax on food insecurity, accounting for the effect of increased food prices.ResultsA 20% tax on palm oil purchases would be expected to avert approximately 363,000 (95% confidence interval 247,000 to 479,000) deaths from myocardial infarctions and strokes over the period 2014-23 in India (1.3% reduction in cardiovascular deaths) if people do not substitute other oils for reduced palm oil consumption. Given estimates of substitution of palm oil with other oils following a 20% price increase for palm oil, the beneficial effects of increased polyunsaturated fat consumption would be expected to enhance the projected reduction in deaths to as much as 421,000 (256,000 to 586,000). The tax would be expected to benefit men more than women and urban populations more than rural populations, given differential consumption and cardiovascular risk. In a scenario incorporating the effect of taxation on overall food expenditures, the tax may increase food insecurity by <1%, resulting in 16,000 (95% confidence interval 12,000 to 22,000) deaths.ConclusionsCurtailing palm oil intake through taxation may modestly reduce hyperlipidemia and cardiovascular mortality, but with potential distributional consequences differentially benefiting male and urban populations, as well as affecting food security.

Project description:BackgroundStrong evidence indicates that excessive time spent sitting (sedentary behaviour) is detrimentally associated with multiple chronic diseases. Sedentary behaviour is prevalent among adults in Australia and has increased during the COVID-19 pandemic. Estimating the potential health benefits and healthcare cost saving associated with reductions in population sitting time could be useful for the development of public health initiatives.MethodsA sedentary behaviour model was developed and incorporated into an existing proportional, multi-state, life table Markov model (ACE-Obesity Policy model). This model simulates the 2019 Australian population (age 18 years and above) and estimates the incidence, prevalence and mortality of five diseases associated with sedentary behaviour (type 2 diabetes, stroke, endometrial, breast and colorectal cancer). Key model inputs included population sitting time estimates from the Australian National Health Survey 2014-2015, healthcare cost data from the Australian Institute of Health and Welfare (2015) and relative risk estimates assessed by conducting literature reviews and meta-analyses. Scenario analyses estimated the potential change in disease incidence as a result of changes in population sitting time. This, in turn, resulted in estimated improvements in long term health outcomes (Health-adjusted life years (HALYs)) and healthcare cost-savings.ResultsAccording to the model, if all Australian adults sat no more than 4 h per day, the total HALYs gained would be approximately 17,211 with health care cost savings of approximately A$185 million over one year. Under a more feasible scenario, where sitting time was reduced in adults who sit 4 or more hours per day by approximately 36 min per person per day (based on the results of the Stand Up Victoria randomised controlled trial), potential HALYs gained were estimated to be 3,670 and healthcare cost saving could reach A$39 million over one year.ConclusionsExcessive sedentary time results in considerable population health burden in Australia. This paper describes the development of the first Australian sedentary behaviour model that can be used to predict the long term consequences of interventions targeted at reducing sedentary behaviour through reductions in sitting time. These estimates may be used by decision makers when prioritising healthcare resources and investing in preventative public health initiatives.

Dataset Information

The economic benefits of reducing cardiovascular disease mortality in Quebec, Canada.

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The economic benefits of reducing cardiovascular disease mortality in Quebec, Canada.

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