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Nutrition and Coronary Heart Disease

effectiveness of different nutrition interventions in the prevention of CHD deaths in the
SWSAHS.

Aim

The aim of this project was to undertake an economic evaluation of alternative
nutritional strategies used in the prevention of coronary heart disease (CHD). The
project assessed both the effectiveness and technical efficiency Ofnutritional
interventions aimed at the prevention of CHD. The analysis was tailored for the South
Western Sydney Area Health Service (SWSAHS), and designed to aid their
management of CHD. The framework established in this paper could also be used as a
management tool in other Area Health Services (AHS) in NSW and beyond.

This paper concentrates on the prevention of CHD, using nutritional interventions. The
method employed was to examine different interventions aimed at specific target
groups. Generally, an intervention can be aimed at three different target groups:

1. high-risk individual (primary and secondary prevention)

2. high-risk group

3. population wide

Cost-Effectiveness Analysis (CEA)

The question posed in this project is as follows: If the SWSAHS Health Promotion Unit
wanted to invest additional funds into nutritional interventions, which intervention would
lead to the prevention of the greatest number of CHD deaths? Given this research question,
it is appropriate to conduct a Cost Effectiveness Analysis (CEA). A CEA uses the tools of
economic costing to ensure technical efficiency is maximised.

The research question is quite specific. It focuses the analysis on the types of
interventions that the SWSAHS Health Promotion Unit employs and hence examines
them from their point of view. Further, this analysis measured the flow-on costs to
other sections of the health care system, but only those which arose as a direct result of
the intervention.

In a CEA, benefits are measured with a common output variable. Examples of
measures include life years saved, number of car crashes prevented, number of people

CHERE Project Report 11 - November 1999



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