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- Title
An economic evaluation of the re-introduction of a school milk program.
- Authors
Dalton, A.; Bass, S.; Lawrence, A.
- Abstract
Background -- Osteoporosis is a major cause of morbidity and mortality in Australia incurring an annual health care cost of approximately $1.9 billion. Although osteoporosis is a disease of the elderly it has been predicted that increasing peak bone mass during growth will significantly delay the onset of osteoporosis during aging, thereby offering improved health outcomes and health care savings over time. Objective -- To determine the potential cost-effectiveness of school milk programs (SMP) compared to current practice. Design -- A semi-Markov model was developed to predict the impact of SMP upon health outcomes and health care costs over life-expectancy. The model allows for transitions between 10 health states comprising 8 different hip and vertebral fracture states, good health, and death. These probabilities were derived from published epidemiological literature, including Australian data wherever possible. The effect size was estimated as an average increase in peak BMD of 1.5%. Outcomes -- Cumulative life-years and quality-adjusted life-years (QALYs) are predicted for cohorts of current children and a hypothetical intervention respectively. Estimated incremental life-years were 0.0096 and 0.0016, and QALYs were 0.0476 and 0.0148 for females and males respectively. Health outcomes and costs are systematically compared to assess cost-effectiveness, that is, 'value-for-money' of SMP. Conclusions -- As expected, gender significantly affects the predicted impacts of SMP. The impacts upon life-expectancy are minimal and provide weak support for funding of SMP. Including morbidity impacts through evaluation of QALYs greatly strengthens the funding argument. At a cost per QALY of less than $25,000, SMP compares favourably with many other health care interventions receiving funding support.
- Subjects
AUSTRALIA; MILK programs; SCHOOL food; CHILD nutrition; OSTEOPOROSIS
- Publication
Asia Pacific Journal of Clinical Nutrition, 2005, Vol 14, pS53
- ISSN
0964-7058
- Publication type
Article