Albrecht M, Krauth C, Rieger J, Lamprecht F, Kersting A, Schwartz F W
Abt. Epidemiologie, Sozialmedizin und Gesundheitssystemforschung, Medizinische Hochschule Hannover.
Gesundheitswesen. 2000 Mar;62(3):156-60. doi: 10.1055/s-2000-10485.
There are only few ambulatory rehabilitation concepts for mothers with psychosomatic disorders (prevalence 5%). Also, only little is known about the evaluation of these programmes. This study compares the socioeconomic evaluations of an ambulatory rehabilitation programme with a post-assistance programme and one without a post-assistance programme. The superior programme should be determined by weighing all relevant costs and benefits. The intensive phase of the ambulatory rehabilitation programme consists of an eight-week treatment with group, single, body and art therapy. The post-assistance programme spans a period of nine-months with 36 sessions of psychoanalytic group therapy. The evaluation of both programme alternatives is made by with the evaluation tool of socioeconomic analyses. For consideration and pricing of costs all direct medical costs, direct non-medical costs and indirect costs are being monitored. Outcomes assessment is realised by cost-effectiveness analysis, cost-utility analysis and cost-benefit analysis. Utilisation of the health care system is being assessed with questionnaires. Measurements are being performed at the beginning and the end of the rehabilitation programme and three, six, nine and twelve months later. Mothers with children aged six years and younger and suffering from various psychosomatic disorders were included in this study. The costs identified for the rehabilitation programme are DM 5571.10 (intensive care and post-assistance programme) and DM 1512.40 (intensive care) per patient. Further progress of the study will show if future cost will differ between the two alternatives. For the comparison of both alternatives all costs will be linked with outcomes. It remains to be seen that additional costs of the post-assistance programme will be compensated with positive outcomes. A sensitivity analysis will show if variation of assumptions will influence the cost-benefit-ratio of the different alternatives.
针对患有身心障碍的母亲(患病率为5%),门诊康复方案寥寥无几。而且,对于这些方案的评估也知之甚少。本研究比较了一个门诊康复方案与一个有后续援助方案和一个没有后续援助方案的社会经济评估。应通过权衡所有相关成本和效益来确定更优方案。门诊康复方案的强化阶段包括为期八周的治疗,采用团体、个体、身体和艺术疗法。后续援助方案为期九个月,包括36次精神分析团体治疗。通过社会经济分析的评估工具对这两种方案进行评估。为了考虑成本并定价,对所有直接医疗成本、直接非医疗成本和间接成本进行监测。通过成本效益分析、成本效用分析和成本效益分析来实现结果评估。利用问卷调查评估医疗保健系统的使用情况。在康复方案开始和结束时以及三个月、六个月、九个月和十二个月后进行测量。本研究纳入了患有各种身心障碍且子女年龄在六岁及以下的母亲。确定的康复方案成本为每位患者5571.10德国马克(重症监护和后续援助方案)和1512.40德国马克(重症监护)。研究的进一步进展将表明这两种方案未来的成本是否会有所不同。为了比较这两种方案,所有成本都将与结果挂钩。后续援助方案的额外成本是否会因积极结果而得到补偿还有待观察。敏感性分析将表明假设的变化是否会影响不同方案的成本效益比。