对精神病高危人群进行早期干预的经济影响。
Economic impact of early intervention in people at high risk of psychosis.
作者信息
Valmaggia L R, McCrone P, Knapp M, Woolley J B, Broome M R, Tabraham P, Johns L C, Prescott C, Bramon E, Lappin J, Power P, McGuire P K
机构信息
OASIS and Department of Psychological Medicine, Institute of Psychiatry, King's College London, UK.
出版信息
Psychol Med. 2009 Oct;39(10):1617-26. doi: 10.1017/S0033291709005613. Epub 2009 Apr 9.
BACKGROUND
Despite the increasing development of early intervention services for psychosis, little is known about their cost-effectiveness. We assessed the cost-effectiveness of Outreach and Support in South London (OASIS), a service for people with an at-risk mental state (ARMS) for psychosis.
METHOD
The costs of OASIS compared to care as usual (CAU) were entered in a decision model and examined for 12- and 24-month periods, using the duration of untreated psychosis (DUP) and rate of transition to psychosis as key parameters. The costs were calculated on the basis of services used following referral and the impact on employment. Sensitivity analysis was used to test the robustness of all the assumptions made in the model.
RESULTS
Over the initial 12 months from presentation, the costs of the OASIS intervention were pound1872 higher than CAU. However, after 24 months they were pound961 less than CAU.
CONCLUSIONS
This model suggests that services that permit early detection of people at high risk of psychosis may be cost saving.
背景
尽管针对精神病的早期干预服务不断发展，但对其成本效益却知之甚少。我们评估了伦敦南部外展与支持服务（OASIS）的成本效益，该服务针对有精神病风险状态（ARMS）的人群。
方法
将OASIS与常规护理（CAU）的成本纳入决策模型，并以未治疗精神病持续时间（DUP）和精神病转变率作为关键参数，对12个月和24个月的时间段进行研究。成本是根据转诊后使用的服务以及对就业的影响来计算的。采用敏感性分析来检验模型中所有假设的稳健性。
结果
从就诊开始的最初12个月里，OASIS干预的成本比常规护理高1872英镑。然而，24个月后，其成本比常规护理少961英镑。
结论
该模型表明，能够早期发现精神病高风险人群的服务可能具有成本节约效益。
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