Economic evaluation of a multi-disciplinary community-based intervention programme for New Zealand children and
Yvonne C Anderson1, William Leung2, Cameron C Grant3
1Department of Paediatrics, Taranaki District Health Board, New Plymouth, New Zealand; Liggins Institute, University of Auckland, Auckland, New Zealand.
Insights
The Whānau Pakari child obesity program, a home-based intervention, proved more cost-effective than traditional hospital care. It achieved similar BMI reductions with lower costs, demonstrating better value for child health.
Area of Science:
- Pediatric Endocrinology
- Public Health Interventions
- Health Economics
Background:
- Childhood obesity is a significant public health concern requiring effective interventions.
- Traditional hospital-based models for pediatric obesity management can be resource-intensive.
- Evaluating the cost-effectiveness of alternative intervention delivery models is crucial for optimizing healthcare resource allocation.
Purpose of the Study:
- To compare the cost-effectiveness of the Whānau Pakari home-based, multidisciplinary child obesity intervention with a conventional hospital-based care model.
- To assess differences in program costs and Body Mass Index Standard Deviation Score (BMI SDS) changes at 12 months.
Main Methods:
- A randomized controlled trial comparing Whānau Pakari (high-intensity and low-intensity arms) with a conventional care group.
- Participants were children aged 4-16 years with obesity or overweight with comorbidities.
- Economic evaluation used participant-level costs and BMI SDS changes from a health funder perspective.
Main Results:
- The Whānau Pakari program demonstrated lower per-child costs compared to the conventional model.
- The low-intensity Whānau Pakari group saved NZ$939 (US$648) per child, and the high-intensity group saved NZ$155 (US$107) per child.
- Reductions in BMI SDS at 12 months were comparable across all three groups.
Conclusions:
- A home-based, multidisciplinary intervention for child obesity is more cost-effective than traditional hospital-based care.
- The Whānau Pakari program offers a scalable and resource-efficient approach to managing childhood obesity.
- Home-based interventions can achieve similar clinical outcomes to hospital-based programs at a reduced cost.
Objective:
To determine whether Whānau Pakari, a home-based, 12-month multi-disciplinary child obesity intervention programme was cost-effective when compared with the prior conventional hospital-based model of care.
Methods:
Whānau Pakari trial participants were recruited January 2012-August 2014, and randomised to either a high-intensity intervention (weekly sessions for 12 months with home-based assessments and advice, n=100) or low-intensity control (home-based assessments and advice only, n=99). Trial participants were aged 5-16 years, resided in Taranaki, Aotearoa/New Zealand (NZ), with a body mass index (BMI) ≥98th centile or BMI >91st centile with weight-related comorbidities. Conventional group participants (receiving paediatrician assessment with dietitian input and physical activity/nutrition support, n=44) were aged 4-15 years, and resided in the same or another NZ centre. The change in BMI standard deviation score (SDS) at 12 months from baseline and programme intervention costs, both at the participant level, were used for the economic evaluation. A limited health funder perspective with costs in 2016 NZ$ was taken.
Results:
The per child 12-month Whānau Pakari programme costs were significantly lower than in the conventional group. In the low-intensity group, costs were NZ$939 (95% CI: 872, 1007) (US$648) lower than the conventional group. In the high-intensity intervention group, costs were NZ$155 (95% CI: 89, 219) (US$107) lower than in the conventional group. BMI SDS reductions were similar in the three groups.
Conclusions:
A home-based, multi-disciplinary child obesity intervention had lower programme costs per child, greater reach, with similar BMI SDS outcomes at 12 months when compared with the previous hospital-based conventional model.
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