[Cost-effectiveness analysis of community-based nutrition interventions in the context of rapid urbanization in Zhejiang Province in 2022].

Objective: Exploring the cost-effectiveness of community-based nutrition interventions in urbanizing areas.

Methods: In January, 2022, 2 communities with typical urbanization process in Hangzhou, Zhejiang Province were selected, and adults aged 18 years or older from each community were recruited as study subjects. Whole venous blood sample was collected. The fully automatic biochemical analyzer was used to detect the hemoglobin in whole blood and the four serum lipids(total cholesterol, triglycerides, high-density lipoprotein, and low-density lipoprotein). The level of serum vitamin D was detected by ultra-high-performance liquid chromatography-tandem mass spectrometry. Meanwhile, the questionnaire survey and health examination at baseline were conducted to acquire the dietary quality score, body mass index(BMI) and waist. According to the inclusion and exclusion criteria, 100 participants were included for each community and divided into four groups, including abnormal fat distribution group, the improper diet group, the vitamin D malnutrition group, and the anemia group. Participant were randomly divided into nutritional intervention and control arms at the match ratio of 1∶1 by age and sex. Continuous nutritional interventions were offered for 3 months for intervention arm, and no intervention was offered for control arm. Repeat survey and health examinations were conducted after 3 months for all participants. The improvements of health indicators related to the four nutritional problems(including BMI, waist, serum lipids, hemoglobin and serum vitamin D) and the relative risk(RR) were calculated. The cost-effectiveness ratios were calculated by integrating the cost.

Results: The improvement rate in the intervention group in abnormal fat distribution group was higher than that of the control group(50% vs.18.8%, RR=2.66). The improvement rate in the intervention group in improper diet group was higher than that of the control group(64.5% vs.43.9%, RR=1.47). The improvement rate in the intervention group in vitamin D malnutrition group was higher than that in the control group(62.5% vs.46.7%, RR=1.34). The improvement rate of anemia intervention group was lower than that of control group(40% vs.60%, RR=0.67). The result of the cost-effectiveness analysis showed that the costs for improving each subject with abnormal fat distribution, improper diet, vitamin D malnutrition and anemia were Chinese Yuan(CNY) 390, CNY 302.3, CNY 408 and CNY 487.5 respectively.

Conclusion: The implementation of community-based nutrition interventions in rapidly urbanizing areas is effective in improving the health status and is in line with the cost-effectiveness principle.