Holder H, Longabaugh R, Miller W R, Rubonis A V
Prevention Research Center, Berkeley, California 94704.
J Stud Alcohol. 1991 Nov;52(6):517-40. doi: 10.15288/jsa.1991.52.517.
This study undertakes an analysis of cost effectiveness of alcoholism treatment modalities based upon (1) findings from clinical trials, (2) costs for treatment in settings and/or by providers and (3) recommendations from treatment experts about appropriate settings, providers and treatment events. This analysis, which assumes a prototypic patient, suggests that modalities with the most evidence of effectiveness (based on three or more clinical trials) are not the most expensive. Within this study, total cost of care was negatively related to effectiveness. Modalities categorized as having insufficient evidence of effectiveness (i.e., lacking three or more clinical trials) are in the higher cost categories. The results of this first effort to establish initial cost/effectiveness considerations are intended to stimulate researchers to conduct the types of clinical studies where both cost and effectiveness are carefully measured to increase the scientific basis for future cost/effect policy considerations. The authors expect future clinical studies will revise the results of this initial effort.
（1）临床试验结果；（2）不同治疗环境和/或治疗提供者的治疗成本；（3）治疗专家关于合适的治疗环境、治疗提供者及治疗项目的建议。该分析以一名典型患者为假设对象，结果表明，有最多有效性证据（基于三项或更多临床试验）的治疗方式并非成本最高的。在本研究中，护理总成本与有效性呈负相关。被归类为有效性证据不足（即缺乏三项或更多临床试验）的治疗方式成本更高。这项首次尝试建立初步成本/效益考量的研究结果旨在激励研究人员开展那些同时仔细衡量成本和有效性的临床研究，从而为未来成本/效益政策考量增加科学依据。作者预计未来的临床研究将修正这一初步研究的结果。
