Beecham Jennifer, Sleed Michelle, Knapp Martin, Chiesa Marco, Drahorad Carla
PSSRU, Cornwallis Building, University of Kent, Canterbury CT2 7NF, UK.
Eur Psychiatry. 2006 Mar;21(2):102-9. doi: 10.1016/j.eurpsy.2005.05.006. Epub 2005 Sep 2.
This paper examines the costs and cost-effectiveness of psychosocial treatment for personality disorder in a controlled study. Using well-validated cost and outcome measures three groups are compared: the One-Stage group (n=32) received 12 months of inpatient treatment; the Step-Down group (n=29) received 6 months of inpatient treatment followed by 12 months of outpatient therapy; and the control group of 47 people used routinely available services. Both specialist programmes were more effective than routine psychiatric services but more costly. Using an extended dominance approach the incremental cost-effectiveness ratio showed that achieving one extra person with clinically relevant outcomes required an investment in the Step-Down programme of around 3400 pound sterling over 18 months. Small sample sizes and non-random allocation to programmes are limitations of this study but the costs and effectiveness findings consistently point to advantages for the shorter residential programme followed by community-based psychotherapeutic support.
本文通过一项对照研究，考察了人格障碍心理社会治疗的成本及成本效益。采用经过充分验证的成本和结果测量方法，对三组进行了比较：单阶段组（n = 32）接受了12个月的住院治疗；递减组（n = 29）接受了6个月的住院治疗，随后是12个月的门诊治疗；47人的对照组使用常规可用服务。两个专科项目都比常规精神科服务更有效，但成本更高。采用扩展优势方法，增量成本效益比表明，在18个月内，递减项目要使另外一人达到临床相关结果，大约需要投入3400英镑。样本量小和项目分配非随机是本研究的局限性，但成本和效益结果一致表明，较短的住院项目随后辅以社区心理治疗支持具有优势。
