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儿童和青少年精神病早期干预服务的经济影响。

The economic impact of early intervention in psychosis services for children and adolescents.

机构信息

Centre for the Economics of Mental and Physical Health, King's College London, London, UK.

出版信息

Early Interv Psychiatry. 2013 Nov;7(4):368-73. doi: 10.1111/eip.12024. Epub 2013 Jan 24.

Abstract

AIMS

To develop and populate a plausible model of the impact of early intervention (EI) for children and adolescents with psychosis to estimate potential short-term health-related cost savings compared to generic Child and Adolescent Mental Health Services (CAMHS).

METHOD

A decision-tree-based model for EI in CAMHS was developed. The model was populated using data relating to the use of inpatient care and EI service activity for people aged under 18 from an area of North East England. Data were abstracted from the National Health Service clinical reporting systems for 2001-2008. Sensitivity analyses were performed to examine costs associated with the model under differing assumptions.

RESULTS

EI delivered cost savings of £4814 per patient compared to care provided by generic CAMHS. Cost savings were predominantly a consequence of reduced length of hospital admissions for patients served by the EI team. The findings were robust to sensitivity analyses.

CONCLUSIONS

These findings suggest that EI services for children and adolescents with psychosis provide potential direct health cost savings comparable to those observed for working-age adults.

摘要

目的

开发和充实一个有关儿童和青少年精神病早期干预(EI)影响的合理模型,以估计与普通儿童和青少年心理健康服务(CAMHS)相比,EI 可能带来的短期医疗成本节约。

方法

为 CAMHS 中的 EI 开发了一个基于决策树的模型。该模型使用了来自英格兰东北部地区的年龄在 18 岁以下人群的住院治疗和 EI 服务活动使用数据进行填充。数据是从 2001-2008 年国家卫生服务临床报告系统中提取的。进行了敏感性分析,以检查在不同假设下模型相关的成本。

结果

与普通 CAMHS 提供的护理相比,EI 每例患者的成本节约为 4814 英镑。成本节约主要是由于 EI 团队服务的患者住院时间缩短所致。敏感性分析结果稳健。

结论

这些发现表明,为儿童和青少年精神病患者提供的 EI 服务提供了潜在的直接医疗成本节约,与观察到的成年劳动力的节约相当。

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