Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
J Rehabil Med. 2011 Jun;43(7):647-52. doi: 10.2340/16501977-0818.
The objective of this study was to examine the intervention costs of a residential community reintegration programme for patients with acquired brain injury and to compare the societal costs before and after treatment.
A cost-analysis was performed identifying costs of healthcare, informal care, and productivity losses. The costs in the year before the Brain Integration Programme (BIP) were compared with the costs in the year after the BIP using the following cost categories: care consumption, caregiver support, productivity losses. Dutch guidelines were used for cost valuation.
Thirty-three cases participated (72% response). Mean age was 29.8 years, 59% traumatic brain injury. The BIP costs were €68,400. The informal care and productivity losses reduced significantly after BIP (p < 0.05), while healthcare consumption increased significantly (p < 0.05). The societal costs per patient were €48,449. After BIP these costs were €39,773; a significant reduction (p < 0.05). Assuming a stable situation the break-even point is after 8 years.
The reduction in societal costs after the BIP advocates the allocation of resources and, from an economic perspective, favours reimbursement of the BIP costs by healthcare insurance companies. However, this cost-analysis is limited as it does not relate costs to clinical effectiveness. :
本研究旨在考察脑损伤患者居住社区康复项目的干预成本，并比较治疗前后的社会成本。
进行成本分析，确定医疗保健、非正式护理和生产力损失的成本。使用以下成本类别比较 Brain Integration Programme（BIP）前一年和 BIP 后一年的成本：护理消耗、护理人员支持、生产力损失。使用荷兰指南进行成本估值。
33 例患者参与（72%的应答率）。平均年龄为 29.8 岁，59%为创伤性脑损伤。BIP 的成本为 68400 欧元。BIP 后，非正式护理和生产力损失显著减少（p<0.05），而医疗保健消耗显著增加（p<0.05）。每位患者的社会成本为 48449 欧元。BIP 后，这些成本为 39773 欧元，显著降低（p<0.05）。假设情况稳定，收支平衡点在 8 年后。
BIP 后社会成本的降低表明需要分配资源，从经济角度来看，支持由医疗保险公司报销 BIP 成本。然而，这种成本分析受到限制，因为它没有将成本与临床效果联系起来。
