Cost-effectiveness of routine and group programs for treatment of obese children.
BACKGROUND
Cost-effectiveness analyses facilitate the allocation of health care resources. The aim of the study was to compare the cost-effectiveness of group treatment, already known to be more effective, with routine counseling in obese children.


METHODS
A prospective 6-month intervention assessed family-based group treatment (15 separate sessions for parents and children) and routine counseling (two appointments for children). Children's weights and heights were measured at baseline, at the end of the intervention and at follow up 6 months later, and the changes in weight for height and body mass index standard deviations scores (BMI-SDS) were calculated and used as main outcome measures. The mean costs and effects of the programs were analyzed to produce the incremental cost-effectiveness ratio, which is an estimate of the additional costs per 1% decrease in weight for height or 0.1 decrease in BMI-SDS. Cost-effectiveness analysis was performed from the perspective of the service provider.


RESULTS
At the end of the intervention, group treatment costs were 1.4-fold (non-calculable 6 months later) when counted per 1% weight for height decrease, and 3.5-fold (2.8-fold 6 months later) when counted per 0.1 BMI-SDS decrease. Incremental cost-effectiveness ratio estimates were euro 53 when calculated for 1% weight for height decrease, and euro 266 (euro 275 6 months later) when calculated for 0.1 BMI-SDS decrease.


CONCLUSIONS
Family-based group treatment is more costly compared with individual routine counseling. Salaries form most of the total costs.
Department of Pediatrics, Kuopio University Hospital, Kuopio, Finland. marja.kalavainen@kuh.fi
Marja
M
Kalavainen
Senja
S
Karjalainen
Janne
J
Martikainen
Matti
M
Korppi
Ismo
I
Linnosmaa
Outi
O
Nuutinen
D052938:Bariatric Medicine / Q000191:economics* / Q000379:methods*; D002648:Child; D003362:Cost-Benefit Analysis; D003376:Counseling / Q000191:economics* / Q000379:methods*; D005190:Family; D005260:Female; D006126:Group Processes; D006801:Humans; D008297:Male; D009765:Obesity / Q000191:economics* / Q000628:therapy*; D015397:Program Evaluation; D011446:Prospective Studies; D016896:Treatment Outcome