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What Is the Best Practice Method for Quantifying the Health and Economic Benefits of Active Transport?

ABSTRACT: The aim of this study was to identify a best practice method to cost the health benefits of active transport for use in infrastructure planning in New South Wales, Australia. We systematically reviewed the international literature covering the concept areas of active transport and cost and health benefits. Original publications describing a method to cost the health benefits of active transport, published in 2000-2019 were included. Studies meeting the inclusion criteria were assessed against criteria identified in interviews with key government stakeholders. A total of 2993 studies were identified, 53 were assessed for eligibility, and 19 were included in the review. The most commonly studied active transport modes were cycling (n = 8) and walking and cycling (n = 6). Exposures considered were physical activity, road transport related injuries and air pollution. The most often applied economic evaluation method was cost benefit analysis (n = 8), and costs were commonly calculated by monetising health outcomes. Based on evaluation of models against the criteria, a Multistate Life Table model was recommended as the best method currently available. There is strong and increasing interest in quantifying and costing the health benefits of active transport internationally. Incorporating health-related economic benefits into existing regulatory processes such as cost benefit analyses could provide an effective way to encourage the non-health sector to include health impacts in infrastructure measures.

SUBMITTER: Moller H

PROVIDER: S-EPMC7503465 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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What Is the Best Practice Method for Quantifying the Health and Economic Benefits of Active Transport?

Möller Holger H Haigh Fiona F Hayek Rema R Veerman Lennert L

International journal of environmental research and public health 20200826 17

The aim of this study was to identify a best practice method to cost the health benefits of active transport for use in infrastructure planning in New South Wales, Australia. We systematically reviewed the international literature covering the concept areas of active transport and cost and health benefits. Original publications describing a method to cost the health benefits of active transport, published in 2000-2019 were included. Studies meeting the inclusion criteria were assessed against cr ...[more]

PMID: 32858934

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Project description:BackgroundGlobally, the status of women's health falls short of its potential. In addition to the deleterious ethical and human rights implications of this deficit, the negative economic impact may also be consequential, but these mechanisms are poorly understood. Building on the literature that highlights health as a driver of economic growth and poverty alleviation, we aim to systematically investigate the broader economic benefits of investing in women's health.MethodsUsing the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, we systematically reviewed health, gender, and economic literature to identify studies that investigate the impact of women's health on micro- and macroeconomic outcomes. We developed an extensive search algorithm and conducted searches using 10 unique databases spanning the timeframe 01/01/1970 to 01/04/2013. Articles were included if they reported on economic impacts stemming from changes in women's health (table of outcome measures included in full review, Table 1). In total, the two lead investigators independently screened 20,832 abstracts and extracted 438 records for full text review. The final review reflects the inclusion of 124 articles.ResultsThe existing literature indicates that healthier women and their children contribute to more productive and better-educated societies. This study documents an extensive literature confirming that women's health is tied to long-term productivity: the development and economic performance of nations depends, in part, upon how each country protects and promotes the health of women. Providing opportunities for deliberate family planning; healthy mothers before, during, and after childbirth, and the health and productivity of subsequent generations can catalyze a cycle of positive societal development.ConclusionsThis review highlights the untapped potential of initiatives that aim to address women's health. Societies that prioritize women's health will likely have better population health overall, and will remain more productive for generations to come.

Project description:ObjectiveFew countries have established national programs to maximize access and reduce operational overheads. We aimed to use patient-level data up to 12 months to model the potential long-term costs and health benefits attributable to implementing such a program for Australia.MethodsA Markov model was created for Australia with an inception population of 10,000 people with stroke presenting to non-urban or suburban hospitals without stroke medical specialists that could receive stroke telemedicine under a national program. Seven Markov states represented the seven modified Rankin Scale (mRS) scores (0 no disability to 6 dead) plus an absorbing state for all other causes of death. The literature informed inputs for the model; for the telemedicine program (including program costs and effectiveness) and patients, these were extrapolated from the Victorian Stroke Telemedicine (VST) program with the initial status of patients being their health state at day 365 as determined by their mRS score. Costs (2018 Australian dollars, healthcare, non-medical, and nursing home) and benefits were reported for both the societal and healthcare perspectives for up to a 25 years (lifetime) time horizon.ResultsWe assumed 4,997 to 12,578 ischemic strokes would arrive within 4.5 h of symptom onset at regional hospitals in 2018. The average per person lifetime costs were $126,461 and $127,987 from a societal perspective or $76,680 and $75,901 from a healthcare system perspective and benefits were 4.43 quality-adjusted life years (QALYs) and 3.98 QALYs gained, respectively, for the stroke telemedicine program and practice without such program. The stroke telemedicine program was associated with a cost saving of $1,526 (from the societal perspective) or an additional $779 (from the healthcare system perspective) and an additional 0.45 QALY gained per patient over the lifetime. The incremental costs of the stroke telemedicine program ($2,959) and management poststroke ($813) were offset by cost savings from rehospitalization (-$552), nursing home care (-$2178), and non-medical resource use (-$128).ConclusionThe findings from this long-term model provide evidence to support ongoing funding for stroke telemedicine services in Australia. Our estimates are conservative since other benefits of the service outside the use of intravenous thrombolysis were not included.

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What Is the Best Practice Method for Quantifying the Health and Economic Benefits of Active Transport?

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What Is the Best Practice Method for Quantifying the Health and Economic Benefits of Active Transport?

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