School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK.
BMC Health Serv Res. 2013 Apr 26;13:150. doi: 10.1186/1472-6963-13-150.
The purpose of the analysis was to develop a health economic model to estimate the costs and health benefits of alternative National Health Service (NHS) service configurations for people with longer-term depression.
Modelling methods were used to develop a conceptual and health economic model of the current configuration of services in Sheffield, England for people with longer-term depression. Data and assumptions were synthesised to estimate cost per Quality Adjusted Life Years (QALYs).
Three service changes were developed and resulted in increased QALYs at increased cost. Versus current care, the incremental cost-effectiveness ratio (ICER) for a self-referral service was £11,378 per QALY. The ICER was £2,227 per QALY for the dropout reduction service and £223 per QALY for an increase in non-therapy services. These results were robust when compared to current cost-effectiveness thresholds and accounting for uncertainty.
Cost-effective service improvements for longer-term depression have been identified. Also identified were limitations of the current evidence for the long term impact of services.
本分析旨在开发一种健康经济模型，以评估英国国家医疗服务体系（NHS）不同服务方案对长期抑郁症患者的成本和健康效益。
本研究采用建模方法，开发了英格兰谢菲尔德长期抑郁症患者现有服务配置的概念性和健康经济模型。综合数据和假设，以估计每质量调整生命年（QALY）的成本。
开发了三种服务变更，结果显示成本增加但 QALYs 增加。与现行护理相比，自我转诊服务的增量成本效益比（ICER）为每 QALY11378 英镑。减少辍学服务的 ICER 为每 QALY2227 英镑，非治疗服务增加 223 英镑。与当前的成本效益阈值进行比较并考虑不确定性时，这些结果是稳健的。
确定了针对长期抑郁症的具有成本效益的服务改进。同时也发现了当前服务对长期影响证据的局限性。
