Authors' objectives:

The assignment given was fairly broad, and due to lack of personnel resources and tight time schedule, the report only cover the following issues: effect of a new GP fee (green prescription) and other interventions that might influence doctors behaviour, effect of interventions aimed at changing patients life style, the cost-effectiveness of changing life style and effect of changes in life style upon utilization and costs of pharmaceutical drugs.

Authors' recommendations: It is possible to influence doctors' behavior through economic incentives (e.g. green prescription), educational visits to doctors' office, audit and feedback, and other initiatives. The effects are most often moderate or even absent, but seem to be stronger when combining several strategies. It is possible to change patients life style (diet, physical activity, smoking habits, drinking habits etc.) with general practitioner advise to patients visiting with another reasons. The effects seem to be better when combining oral information with other initiatives such as written material and patient follow-up. The effects are most frequently weak and decreasing over time. Life-style changes through change of diet and physical activity can be cost-effective in the sense that quality and length of life are improved at an acceptable cost for society. The studies are partly based on optimistic projections about behavior change, and it is doubtful whether the initiatives will turn out to be cost-effective. It is possible to reduce the use of medications with life-style interventions, but it might be more costly to carry out the interventions than the savings from less use of medications. Only a few studies explored effect on life expectancy, but there is little evidence that change of physical activity and diet may yield more than a few months on average. Patient co-payments tend to reduce the use of preventive services. This effect seems to be strongest in low socioeconomic groups.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.nokc.no/

Year Published: 2003

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Norway

Organisation Name: Norwegian Institute of Public Health

Contact Address: Universitetsgata 2, Postbox 7004 St. Olavs plass, NO-0310 Oslo NORWAY. Tel: +47 23 25 50 00; Fax: +47 23 25 50 10;

Contact Name: Berit.Morland@nokc.no, dagny.fredheim@nokc.no

Contact Email: Berit.Morland@nokc.no, dagny.fredheim@nokc.no

Copyright: The Norwegian Knowledge Centre for the Health Services