Costs and cost effectiveness of health checks conducted by nurses in primary care: the Oxcheck study.
OBJECTIVE
To measure the costs and cost effectiveness of the Oxcheck cardiovascular risk factor screening and intervention programme.


METHODS
Cost effectiveness analysis of a randomised controlled trial using clinical and economic data taken from the trial.


METHODS
Five general practices in Luton and Dunstable, England.


METHODS
2205 patients who attended a health check in 1989-90 and were scheduled for re-examination in 1992-3 (intervention group); 1916 patients who attended their initial health check in 1992-3 (control group). Participants were men and women aged 35-64 years.


METHODS
Health check conducted by nurse, with health education and follow up according to degree of risk.


METHODS
Cost of health check programme; cost per 1% reduction in coronary risk.


RESULTS
Health check and follow up cost 29.27 pounds per patient. Estimated programme cost per 1% reduction in coronary risk per participant was between 1.46 pounds and 2.25 pounds; it was nearly twice as much for men as women.


CONCLUSIONS
The cost to the practice of implementing Oxcheck-style health checks in an average sized practice of 7500 patients would be 47,000 pounds, a proportion of which could be paid for through staff pay reimbursements and Band Three health promotion target payments. This study highlights the considerable difficulties faced when calculating the costs and benefits of a health promotion programme. Economic evaluations should be integrated into the protocols of randomised controlled trials to enable judgments to be made on the relative cost effectiveness of different prevention strategies.
Langham
S
S
Department of Public Health and Policy, London School of Hygiene and Tropical Medicine.
Thorogood
M
M
Normand
C
C
Muir
J
J
Jones
L
L
Fowler
G
G
D000328:Adult; D002318:Cardiovascular Diseases / Q000191:economics / Q000451:nursing / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D004739:England; D005194:Family Practice / Q000191:economics; D005260:Female; D017048:Health Care Costs; D006293:Health Promotion; D006302:Health Services Research / Q000191:economics*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics*; D008875:Middle Aged; D009730:Nursing Assessment / Q000191:economics*; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors