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Korean Journal of Preventive Medicine 2002;35(2): 99-106.
Cost-Effectiveness Analysis of a Hyperlipidemia Mass Screening Program in Korea.
Yeon Soon Cha, Young Ho Khang, Moo Song Lee, Weechang Kang, Sung Hoon Jeon, Kee Lak Kim, Sang Il Lee
1Department of Preventive Medicine, University of Ulsan College of Medicine, Korea.
2Department of Information and Statistics, Daejeon University, Korea.
3Health Promotion Center, Asan Medical Center, Korea.
ABSTRACT
OBJECTIVE: Until now, there have been no evidence-based guidelines produced for the mass screening of hyperlipidemia cases in Korea. This study was done to find the most efficient strategy for a hyperlipidemia-screening program among Korean adults. METHOD: Seven alternative strategies for hyperlipidemia screening were formulated and compared in terms of cost-effectiveness. Cost and effectiveness were estimated from social perspectives and using a two-stage screening process (initial testing and additional testing for positives from the first test). A computerized database (based on persons who had visited a health promotion center in one teaching hospital for a routine health check-up) was used to determine the cost and the outcome of various strategies. Official data was used in calculating direct and indirect costs. Effectiveness was measured according to the number of persons who needed clinical intervention for hyperlipidemia. A stratified analysis, considering age group and sex, was then done. Sensitivity analyses, focusing on several uncertain parameters, were also done. RESULTS: Of the seven test alternatives available, the most cost-effective strategy was a screening program, which consisted of an initial test of total cholesterol,high-density lipoprotein cholesterol and triglyceride. There was some variation in the rank of the cost-effectiveness ratios for the seven alternatives dependent on age group or gender. CONCLUSIONS: Current hyperlipidemia screening practice, for National Health Insurance beneficiaries, tests only the total cholesterol level with a cut-off value of 260mg/dl as an initial screening test. It is not the best strategy for cost-effectiveness, and should be modified. Different screening strategies taking age group and sex into account should be developed and used for the efficient mass screening of hyperlipidemia cases among Korean adults.
Key words: Hyperlipidemia; Mass screening; Cost-effectiveness
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