To analyze the value of studying or implementing office-based clinical preventive services for adolescents.
Most adolescent mortality and morbidity is attributable to risk behaviors, yet clinical preventive services to reduce risk behaviors are often challenged because their efficacy has not been demonstrated.
A cost-effectiveness model of adolescents'risky behaviors that compares standard practice with a program of screening visits for all adolescents and counseling visits for youth identified as high risk.
We considered two risk behaviors, alcohol abuse and unsafe sexual activity, and five outcomes.
Baseline cost-effectiveness of the program, minimum efficacy at which the program would be cost-effective, and sample sizes required for a trial of the program.
Assuming that the program is 5% effective at preventing risk behaviors, it would cost $3035 to prevent any one adverse outcome and $471000 to prevent a death from an automobile crash or from human immunodeficiency virus infection.
Assuming society were willing to pay $600 000 to prevent a death (a generally accepted figure), the program would be cost-effective only if it were 5.6% effective at changing behavior.
At this efficacy, the program would have a cost per year of life saved comparable to or better than many other accepted medical interventions.
Mots-clés Pascal : Etats Unis, Evaluation, Prévention, Programme sanitaire, Santé, Adolescent, Risque élevé, Service santé, Analyse coût efficacité, Economie santé, Modèle prévision, Amérique du Nord, Amérique, Homme
Mots-clés Pascal anglais : United States, Evaluation, Prevention, Sanitary program, Health, Adolescent, High risk, Health service, Cost efficiency analysis, Health economy, Forecast model, North America, America, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0278085
Code Inist : 002B30A01C. Création : 01/03/1996.