Wolfs Claire A G, Dirksen Carmen D, Kessels Alfons, Severens Johan L, Verhey Frans R J
Department of Psychiatry and Neuropsychology, University Hospital of Maastricht/Alzheimer Centre Limburg, Maastricht, the Netherlands.
Arch Gen Psychiatry. 2009 Mar;66(3):313-23. doi: 10.1001/archgenpsychiatry.2008.544.
Because of the increasing number of elderly people with dementia, the costs of dementia and dementia care are expected to grow rapidly in the coming decades. Cost-effectiveness results are relevant for decision making about new strategies in dementia care.
To evaluate the cost-effectiveness of an integrated multidisciplinary diagnostic facility for diagnosing dementia in ambulatory psychogeriatric patients.
Randomized controlled trial with an economic evaluation component.
The Maastricht Evaluation of a Diagnostic Intervention for Cognitively Impaired Elderly, Maastricht University Hospital, Maastricht, the Netherlands.
A total of 137 patients who received care in the multidisciplinary diagnostic facility and 93 who received usual care.
Quality-adjusted life-years (QALYs) as the main outcome measure and cognition and behavioral problems as secondary outcome measures.
Compared with patients receiving usual care, patients who visited the diagnostic facility gained a mean 0.05 QALY at the extra cost of euro65. The incremental cost per QALY amounted to euro1267. This point estimate lies beneath commonly accepted thresholds and is within an acceptable range of uncertainty. With regard to the secondary analyses, cost-effectiveness results showed a substantial amount of uncertainty and were therefore indecisive.
On the basis of the main cost-per-QALY analysis, the use of the integrated multidisciplinary diagnostic facility is cost-effective for the diagnosis and management of dementia in ambulatory patients.
由于老年痴呆症患者数量不断增加，预计在未来几十年中，痴呆症及痴呆症护理的成本将迅速增长。成本效益结果对于痴呆症护理新策略的决策具有重要意义。
评估一种综合多学科诊断设施在门诊老年精神病患者中诊断痴呆症的成本效益。
带有经济评估成分的随机对照试验。
荷兰马斯特里赫特大学医院的认知障碍老年人诊断干预马斯特里赫特评估。
共有137名在多学科诊断设施接受护理的患者和93名接受常规护理的患者。
以质量调整生命年（QALYs）作为主要结局指标，认知和行为问题作为次要结局指标。
与接受常规护理的患者相比，前往诊断设施就诊的患者平均获得了0.05个质量调整生命年，但额外花费了65欧元。每质量调整生命年的增量成本为1267欧元。这一点估计值低于普遍接受的阈值，且处于可接受的不确定性范围内。关于次要分析，成本效益结果显示存在大量不确定性，因此无法得出决定性结论。
基于主要的每质量调整生命年成本分析，使用综合多学科诊断设施对于门诊患者痴呆症的诊断和管理具有成本效益。
