Targeted cardiovascular screening in the Pakistani/Bangladeshi group identified 68.7% of the high-risk population at a cost of £59 per person, compared to 19.2% and £98 in the general population.
Cross-Sectional (n=9,407)
Does targeted screening compared to mass screening improve cost-effectiveness for identifying high cardiovascular risk across different ethnic groups?
Cardiovascular screening, whether targeted or universal, is more cost-effective in South Asian ethnic groups than in the general population, highlighting its potential to reduce ethnic health inequalities.
OBJECTIVES: To investigate ethnic differences in the cost-effectiveness of targeted and mass screening for high cardiovascular risk. DESIGN: Simulation of two screening strategies (targeted screening of most deprived areas and mass screening) using cross-sectional data from Health Survey for England. SETTING: England. SUBJECTS: 9407 adults aged 40-74 years (493 Black Caribbean, 532 Indian, 516 Pakistani/Bangladeshi, 617 Irish and 7249 general population of whom 6633 were White). MAIN OUTCOME MEASURES: Coverage of high-risk population, number needed to screen to identify one person at high cardiovascular risk and cost-effectiveness of targeted screening, with incremental analysis of expanding targeted to mass screening. RESULTS: Coverage, number needed to screen and cost-effectiveness of targeted screening were better in all ethnic minority groups compared with the White group and general population. Targeted screening would identify 19.2% of high-risk individuals in the general population, and require 4.1 people to be screened to identify one person at high cardiovascular risk at a cost of £98. In the Pakistani/Bangladeshi group, 68.7% of the high-risk population would be identified, and only 2.5 people would need to be screened at a lower cost of £59. In comparison with targeted screening, mass screening was less cost-effective overall but the cost per additional high-risk individual detected was the lowest among the South Asian groups (Indian £130 and Pakistani/Bangladeshi £94). CONCLUSIONS: Irrespective of whether cardiovascular screening is targeted or universal, it is more cost-effective in South Asian ethnic groups than in the general population. Therefore, cardiovascular screening has the potential to reduce ethnic health inequalities.
Baker et al. (2013) conducted a cross-sectional in High cardiovascular risk (n=9,407). Targeted screening vs. Mass screening was evaluated on Coverage of high-risk population, number needed to screen, and cost-effectiveness. Targeted cardiovascular screening in the Pakistani/Bangladeshi group identified 68.7% of the high-risk population at a cost of £59 per person, compared to 19.2% and £98 in the general population.