Cost-effectiveness analysis of public health interventions

Abstract

Building on Chapter 2, which introduced the reader to the purpose, principles, and statistical methods of cost-effectiveness analysis, this chapter provides a case study of a cost-effectiveness analysis undertaken alongside a trial of a public health intervention conducted by Edwards and colleagues into enhancing ventilation in homes of children with asthma. The association between poor housing and ill-health has long been recognized. This chapter reproduces in full a paper reporting the CHARISMA study, one of the first economic evaluation studies worldwide alongside a pragmatic randomized controlled trial of improving heating and ventilation in the homes of children with asthma. In summary, tailored ventilation and heating modifications moved 17 per cent of children in the intervention group from below the original median (‘severe asthma’) to above that median (‘moderate asthma’), while only 3 per cent of controls moved from ‘severe’ to ‘moderate’. Thus, a net 14 per cent of children (or 29 per cent of children with ‘severe’ asthma) became ‘moderate’.