Estimating the Relative Impact of Clinical and Preventive Community-Based Interventions: An Example Based on the Community Transformation Grant Program

Details

• Journal Article:
  Preventing Chronic Disease (PCD)
• Personal Author:
  Yarnoff, Benjamin ; Bradley, Christina ; Honeycutt, Amanda A. ; Soler, Robin E. ; Orenstein, Diane
• Description:
  Introduction
  
  Public health focuses on a range of evidence-based approaches for addressing chronic conditions, from individual-level clinical interventions to broader changes in policies and environments that protect people’s health and make healthy living easier. This study examined the potential long-term impact of clinical and community interventions as they were implemented by Community Transformation Grant (CTG) program awardees.
  
  Methods
  
  We used the Prevention Impacts Simulation Model, a system dynamics model of cardiovascular disease prevention, to simulate the potential 10-year and 25-year impact of clinical and community interventions implemented by 32 communities receiving a CTG program award, assuming that program interventions were sustained during these periods.
  
  Results
  
  Sustained clinical interventions implemented by CTG awardees could potentially avert more than 36,000 premature deaths and $3.2 billion in discounted direct medical costs (2017 US dollars) over 10 years and 109,000 premature deaths and $8.1 billion in discounted medical costs over 25 years. Sustained community interventions could avert more than 24,000 premature deaths and $3.4 billion in discounted direct medical costs over 10 years and 88,000 premature deaths and $9.1 billion in discounted direct medical costs over 25 years. CTG clinical activities had cost-effectiveness of $302,000 per death averted at the 10-year mark and $188,000 per death averted at the 25-year mark. Community interventions had cost-effectiveness of $169,000 and $57,000 per death averted at the 10- and 25-year marks, respectively.
  
  Conclusion
  
  Clinical interventions have the potential to avert more premature deaths than community interventions. However, community interventions, if sustained over the long term, have better cost-effectiveness.
  
  
• Subjects:
  Original Research
• Source:
  Prev Chronic Dis. 16
• DOI:
  http://dx.doi.org/10.5888/pcd16.180594
• ISSN:
  1545-1151
• Pubmed ID:
  31274409
• Pubmed Central ID:
  PMC6638589
• Document Type:
  Journal Article
• Volume:
  16
• Collection(s):
  Preventing Chronic Disease
• Main Document Checksum:
  urn:sha-512:9aa1adfcbcf3f36de633b774988a6635379d4f07e9f2c76614355216ed0f884a9ba157798786c2f0eb24903d4a1a1aa86408e4fb868384992d421580d970a348
• Download URL:
  https://stacks.cdc.gov/view/cdc/80205/cdc_80205_DS1.pdf
• File Type:
  [PDF - 303.48 KB ]