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- Cost-Effectiveness Analysis of a Hyperlipidemia Mass Screening Program in Korea.
- Yeon Soon Cha, Young Ho Khang, Moo Song Lee, Weechang Kang, Sung Hoon Jeon, Kee Lak Kim, Sang Il Lee
- Korean J Prev Med. 2002;35(2):99-106.
- 2,485 View
- 35 Download
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Abstract
PDF - OBJECTIVE
Until now, there have been no evidence-based guidelines produced for the mass screening of hyperlipidemia cases in Korea. This study was done to find the most efficient strategy for a hyperlipidemia-screening program among Korean adults. METHOD: Seven alternative strategies for hyperlipidemia screening were formulated and compared in terms of cost-effectiveness. Cost and effectiveness were estimated from social perspectives and using a two-stage screening process (initial testing and additional testing for positives from the first test). A computerized database (based on persons who had visited a health promotion center in one teaching hospital for a routine health check-up) was used to determine the cost and the outcome of various strategies. Official data was used in calculating direct and indirect costs. Effectiveness was measured according to the number of persons who needed clinical intervention for hyperlipidemia. A stratified analysis, considering age group and sex, was then done. Sensitivity analyses, focusing on several uncertain parameters, were also done. RESULTS: Of the seven test alternatives available, the most cost-effective strategy was a screening program, which consisted of an initial test of total cholesterol,high-density lipoprotein cholesterol and triglyceride. There was some variation in the rank of the cost-effectiveness ratios for the seven alternatives dependent on age group or gender. CONCLUSIONS: Current hyperlipidemia screening practice, for National Health Insurance beneficiaries, tests only the total cholesterol level with a cut-off value of 260mg/dl as an initial screening test. It is not the best strategy for cost-effectiveness, and should be modified. Different screening strategies taking age group and sex into account should be developed and used for the efficient mass screening of hyperlipidemia cases among Korean adults. -
Summary
- The Risk Factors Associated with Increased Blood Pressure, Sugar and Lipids in Multi-phasic Health Checkup Examinee.
- Kang Sook Lee, Sang Deog Cho, Hyun Sook Hong
- Korean J Prev Med. 2000;33(1):69-75.
- 2,010 View
- 24 Download
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Abstract
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- OBJECTIVES
This study was conducted to evaluate the risk factors associated with cardiovascular disease. METHODS: By the questionnaire, the informations of education level, monthly income, alcohol consumption and smoking habit were obtained. Height, weight and blood pressure(BP) were measured by a trained nurse. The level of fasting blood sugar(FBS), total cholesterol, hight-density lipoprotein(HDL) cholesterol and triglyceride were tested by enzyme method about a group of 2888 males and 1696 females ages over 20 who had never taken the medication for hypertension. Statistical analysis, ANOVA, stepwise multiple regression, correlation analysis were performed using SAS package program. RESULTS: There were significant differences among age groups in systolic and diastolic blood pressure, body mass index(BMI), FBS, triglyceride and cholesterol except HDL-cholesterol. The risk factors associated with systolic and diastolic BP significantly in male were BMI, age, alcohol intake, but in female BMI, age. Smoking habit had a significant negative correlation with BP in both sex. In the group of mild hypertension (> or =140 mmHg or> or =90 mmHg defined by JNC-VI) and hypertension (> or =160 mmHg or > or = 95 mmHg defined by WHO), the percent of diabetes (FBS> or =140 mg/dl), hypercholesterolemia (> or =240 mg/dl), and hypertriglyceridemia (> or =200 mg/dl) were signifcantly higher compared with normal group in male and female. BMI, and alcohol consumption had a positive correlation with FBS, total cholesterol and triglyceride. Smoking had a positive correlation with cholesterol and triglyceride but negative correlation with HDL-cholesterol in male. The educational attainment had a negative correlation with BMI, FBS, total cholesterol and triglyceride in female. CONCLUSIONS: This study suggested that drinking, smoking, and BMI and lower educational level were associated with hypertension, hyperlipidemia and diabetes, but further evaluation was needed by prospective intervention study. -
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