Foley Louise, Maddison Ralph, Jones Zanta, Brown Paul, Davys Anne
Clinical Trials Research Unit, University of Auckland, Private Bag 92019, Auckland Mail Centre, Auckland 1142, New Zealand.
N Z Med J. 2011 Jul 8;124(1338):44-54.
Green Prescription (GRx) referrals from health professionals have been shown to be effective for increasing the physical activity levels of patients. Little is known about which methods of delivering the programme represents the best value for money. The purpose of this paper was to compare the cost and outcomes of two modes of delivery of a GRx programme. One mode offered phone support involving monthly telephone calls over a 3-4 month period to encourage physical activity participation. A second mode offered community support via weekly face-to-face support group meetings in which physical activities were offered.
The evaluation involved staff interviews, patient interviews and analysis of GRx records for the 2007 calendar year.
There was a large rate of drop-out (68%) from GRx referral to registration. For those who registered, there was a clear preference for community support, and engagement of Maori and Pacific peoples was higher in this mode of delivery. The proportion (but not absolute number) of people who successfully completed their mode of delivery was higher with phone support. However, participants in community support self-reported a significantly greater number of days of exercise per week than those in phone support. The total expected cost per person for phone support was $102.07 and $108.15 for community support. A greater proportion of participants in community support were very satisfied overall with their mode of delivery.
The two modes were comparable in cost and outcomes, though there was greater penetration of target ethnic populations in community support. Providing a choice of GRx mode of delivery allows participants to choose based on their personal and cultural needs.
健康专业人员开出的绿色处方（GRx）转诊已被证明对提高患者的身体活动水平有效。对于哪种提供该项目的方法性价比最高，人们知之甚少。本文的目的是比较GRx项目两种交付模式的成本和结果。一种模式提供电话支持，在3 - 4个月的时间里每月进行电话沟通，以鼓励参与体育活动。另一种模式通过每周面对面的支持小组会议提供社区支持，会议中会安排体育活动。
评估包括员工访谈、患者访谈以及对2007年日历年GRx记录的分析。
从GRx转诊到登记的退出率很高（68%）。对于那些登记的人来说，他们明显更倾向于社区支持，并且在这种交付模式下，毛利人和太平洋岛民的参与度更高。通过电话支持成功完成其交付模式的人数比例（而非绝对数量）更高。然而，社区支持组的参与者自我报告每周锻炼的天数明显多于电话支持组。电话支持的人均预期总成本为102.07美元，社区支持为108.15美元。社区支持组中更大比例的参与者对其交付模式总体非常满意。
两种模式在成本和结果方面具有可比性，尽管社区支持模式对目标族裔人群的渗透率更高。提供GRx交付模式的选择能让参与者根据个人和文化需求进行选择。
