Costs for screening, intervention and hospital treatment generated by the Malmö Preventive Project: a large-scale community screening programme.
OBJECTIVE
The purpose of this study was to estimate retrospectively the costs of health care resources used in the Malmö Preventive Project, Sweden and estimate the costs of in-patient care that were avoided because of early intervention.


METHODS
A large-scale community intervention programme was conducted from 1974 to 1992 in Malmö, Sweden with the aim of reducing morbidity and mortality of cardiovascular diseases (CVD), alcohol related illnesses, and breast cancer. Between 1974 and 1992, 33 336 male and female subjects were screened for hypertension, hyperlipidaemia, type-2 diabetes and alcohol abuse. Intervention programmes that included life-style modifications, follow-up visits with physicians and nurses and drug therapy were offered to about 25% of screened subjects.


METHODS
Recruitment costs were generated through out the screening period. Intervention costs were estimated for 5 years after screening. Excess in-patient care costs were estimated by subtracting hospital consumption for an unscreened, matched cohort from that of the screened cohort over follow-up periods of 13-19 years. Intervention and excess in-patient care costs were estimated until 1996.


RESULTS
The net expenditures for recruitment and intervention was SEK253 million and saved costs for in-patient care of SEK143 millions (1998 prices). Considering the opportunity cost of the resources used in the study, the net cost rises to about SEK200 millions.


CONCLUSIONS
The results suggest that only part of the intervention costs were offset by reduction in future morbidity health care costs. This is in line with results from prospective analyses of other primary prevention programmes.
Norinder
A
A
Swedish Institute for Health Economics (IHE), Lund, Sweden. an@ihe.se
Persson
U
U
Nilsson
P
P
Nilsson
J-A
JA
Hedblad
B
B
Berglund
G
G
D000328:Adult; D019973:Alcohol-Related Disorders / Q000517:prevention & control*; D000437:Alcoholism / Q000175:diagnosis; D001943:Breast Neoplasms / Q000517:prevention & control*; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis; D005260:Female; D017048:Health Care Costs; D017721:Hospital Costs; D006801:Humans; D006949:Hyperlipidemias / Q000175:diagnosis; D006973:Hypertension / Q000175:diagnosis; D008297:Male; D008403:Mass Screening / Q000191:economics*; D008875:Middle Aged; D011314:Preventive Health Services / Q000191:economics*; D012189:Retrospective Studies; D012307:Risk Factors; D013548:Sweden