Rheumatic fever and rheumatic heart disease: primary prevention is the cost effective option.
OBJECTIVE
To measure the economic output/input ratios for the various options of prevention of rheumatic fever/rheumatic heart disease (RF/RHD) and check the viability of primary prevention vis-à-vis secondary and tertiary preventions.


METHODS
Cost accounting of the various prevention options was calculated for each variable as available in literature. Actual data as obtainable for the financial year ending March 2006 were computed for the Pondicherry population. Both direct and indirect costs (including community/social costs) were worked out using mostly primary data and wherever necessary, secondary data. Certain scientific assumptions were used where exact data was not available.


RESULTS
Primary prevention is the definite viable economic option (1:1.56) compared to secondary (1: 1.07) and tertiary (1: 0.12) preventions. In fact, the current stress on only secondary and tertiary preventions is found to be economically unviable.


CONCLUSIONS
It is postulated that primary prevention as a practical policy in tackling RF and RHD can be recommended.
Soudarssanane
M B
MB
Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India. drmybase@sify.com
Karthigeyan
M
M
Mahalakshmy
T
T
Sahai
Ajit
A
Srinivasan
S
S
Subba Rao
K S V K
KS
Balachander
J
J
D002648:Child; D002675:Child, Preschool; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D003906:Developing Countries; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007194:India; D008297:Male; D011322:Primary Prevention / Q000191:economics* / Q000379:methods; D012213:Rheumatic Fever / Q000191:economics* / Q000517:prevention & control*; D012214:Rheumatic Heart Disease / Q000191:economics / Q000517:prevention & control