Economic evaluation of the direct healthcare cost savings resulting from the use of walking interventions to prevent cor
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Economic evaluation of the direct healthcare cost savings resulting from the use of walking interventions to prevent coronary heart disease in Australia Henry Zheng · Fred Ehrlich · Janaki Amin
Received: 28 October 2008 / Accepted: 19 September 2009 / Published online: 1 November 2009 © Springer Science+Business Media, LLC 2009
Abstract Coronary heart disease (CHD) is the leading cause of death in Australia. Direct healthcare costs of CHD exceed those of any other disease. The purpose of this study was to evaluate the direct healthcare cost savings resulting from walking interventions to prevent CHD in Australia. A meta-analysis was performed to quantify the efficacy of walking interventions in preventing CHD. The etiologic fraction and other mathematical models were applied to quantify the cost savings resulting from walking interventions to prevent CHD. The net direct healthcare cost savings in CHD prevention resulting from 30 min of normal walking a day for 5–7 days a week by the sufficient walking population were estimated at AU$126.73 million in 2004. The cost savings could increase to $419.90 million if all the inactive adult Australians engaged in 1 h of normal walking a day for 5–7 days a week. Given its low injury risk and high adherence, walking should be advocated as a key population-based primary intervention strategy for CHD prevention and healthcare cost reduction. Keywords Coronary heart disease · Cost savings · Healthcare cost · Physical activity · Walking · Meta-analysis JEL Classification
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H. Zheng (B) · F. Ehrlich School of Public Health and Community Medicine, The University of New South Wales, Level 2, Samuels Building, Sydney, NSW, Australia e-mail: [email protected] J. Amin National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, NSW, Australia
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Introduction The health expenditure in Australia more than doubled from $36.99 billion in 1993–1994 to $78.60 billion in 2003–2004 (Australian Institute of Health and Welfare 2005). By 2006– 2007, the total expenditure on health goods and services reached $94 billion, or $4,507 person. This was over $7 billion or $286 per person more than the previous year. For the decade from 1996–1997 to 2006–2007, the average annual real growth in health expenditure exceeded that of GDP, resulting in a substantial increase in the health expenditure to gross domestic product (GDP) ratio (Australian Institute of Health and Welfare 2008b). It is projected that the total healthcare expenditure together with residential aged care expenditure will almost triple from $85 billion in 2003 to $246 billion by 2033. This represents an increase from 9.3% of the GDP in 2002–2003 to 12.4% of the GDP in 2032–33 (Goss 2008). Cardiovascular disease (CVD) is the most expensive disease group in Australia, accounting for 11% of the total health expenditure in 2004–2005. Between 2000–2001 and 2004– 2005, inflation adjusted expenditure on cardiovascular diseases increased by 18% (Australian Instit
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