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  4. Cost-effectiveness analysis of a European primary-care physician training in smoking cessation counseling.
 
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Titre

Cost-effectiveness analysis of a European primary-care physician training in smoking cessation counseling.

Type
article
Institution
UNIL/CHUV/Unisanté + institutions partenaires
Périodique
European journal of cardiovascular prevention and rehabilitation  
Auteur(s)
Pinget, C.
Auteure/Auteur
Martin, E.
Auteure/Auteur
Wasserfallen, J.B.
Auteure/Auteur
Humair, J.P.
Auteure/Auteur
Cornuz, J.
Auteure/Auteur
Liens vers les personnes
Cornuz, Jacques  
Wasserfallen, Jean-Blaise  
Pinget, Christophe  
Liens vers les unités
Inst. d'économie et manag. santé  
Médecine sociale et préventive (IUMSP)  
Service de médecine interne  
ISSN
1741-8267
Statut éditorial
Publié
Date de publication
2007
Volume
14
Numéro
3
Première page
451
Dernière page/numéro d’article
455
Peer-reviewed
Oui
Langue
anglais
Résumé
BACKGROUND: Physician training in smoking cessation counseling has been shown to be effective as a means to increase quit success. We assessed the cost-effectiveness ratio of a smoking cessation counseling training programme. Its effectiveness was previously demonstrated in a cluster randomized, control trial performed in two Swiss university outpatients clinics, in which residents were randomized to receive training in smoking interventions or a control educational intervention. DESIGN AND METHODS: We used a Markov simulation model for effectiveness analysis. This model incorporates the intervention efficacy, the natural quit rate, and the lifetime probability of relapse after 1-year abstinence. We used previously published results in addition to hospital service and outpatient clinic cost data. The time horizon was 1 year, and we opted for a third-party payer perspective. RESULTS: The incremental cost of the intervention amounted to US$2.58 per consultation by a smoker, translating into a cost per life-year saved of US$25.4 for men and 35.2 for women. One-way sensitivity analyses yielded a range of US$4.0-107.1 in men and US$9.7-148.6 in women. Variations in the quit rate of the control intervention, the length of training effectiveness, and the discount rate yielded moderately large effects on the outcome. Variations in the natural cessation rate, the lifetime probability of relapse, the cost of physician training, the counseling time, the cost per hour of physician time, and the cost of the booklets had little effect on the cost-effectiveness ratio. CONCLUSIONS: Training residents in smoking cessation counseling is a very cost-effective intervention and may be more efficient than currently accepted tobacco control interventions.
Sujets

Adult

Computer Simulation

Cost-Benefit Analysis...

Directive Counseling

Education, Medical, G...

Feasibility Studies

Female

Health Care Costs

Humans

Internship and Reside...

Male

Markov Chains

Middle Aged

Models, Economic

Physicians

Primary Health Care

Quality-Adjusted Life...

Referral and Consulta...

Smoking Cessation

Switzerland

PID Serval
serval:BIB_B1466898699B
DOI
10.1097/HJR.0b013e32804955a0
PMID
17568248
WOS
000247822100017
Permalien
https://iris.unil.ch/handle/iris/171816
Date de création
2008-03-14T09:12:35.061Z
Date de création dans IRIS
2025-05-21T00:15:53Z
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