Latimer Eric A, Garièpy Geneviéve, Greenfield Brian
Professor, Department of Psychiatry, McGill University, Montreal, Quebec; Research Scientist, Douglas Mental Health University Institute, Montreal, Quebec.
Student, Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec.
Can J Psychiatry. 2014 Jun;59(6):310-8. doi: 10.1177/070674371405900604.
To investigate the cost-effectiveness of a rapid response team (RRT), compared with usual care (UC), for treating suicidal adolescents.
Suicidal adolescents (n = 286) presenting at an emergency department were enrolled in a trial to compare UC with enhanced outpatient care provided by an RRT of health professionals. Functioning (Child Global Assessment Scale) and suicidality (Spectrum of Suicidal Behavior Scale) scores were measured at baseline and 6 months later. Resource use and cost data were collected from several sources during the same period.
As previously reported, there was no statistically or clinically significant difference in either functioning or suicidality between the groups. Costs of the RRT were lower by $1886, thus -$1886 (95% CI -$4238 to $466), from the perspective of the treating hospital, and by $991, thus -$991 (95% CI -$5580 to $3598), from the perspective of society. If decision makers are not willing to pay for any improvement in functioning or suicidality, the RRT has a 95% probability of being cost-effective from the perspective of the treating hospital. From the point of view of society, the probability of the intervention being cost-effective is about 70% for functioning and 63% for suicidality. The difference between the 2 perspectives is mainly attributable to the cost of hospitalizations outside the treating hospital.
An RRT intervention appears to be cost-effective, compared with UC, from the point of view of the treating hospital, but there is no difference from the point of view of society.
研究快速反应小组（RRT）与常规护理（UC）相比，治疗自杀倾向青少年的成本效益。
将在急诊科就诊的自杀倾向青少年（n = 286）纳入一项试验，以比较常规护理与由健康专业人员组成的快速反应小组提供的强化门诊护理。在基线和6个月后测量功能（儿童整体评估量表）和自杀倾向（自杀行为量表）得分。在同一时期从多个来源收集资源使用和成本数据。
如先前报道，两组在功能或自杀倾向方面均无统计学或临床显著差异。从治疗医院的角度来看，快速反应小组的成本降低了1886美元，即-1886美元（95%CI -4238美元至466美元），从社会角度来看，成本降低了991美元，即-991美元（95%CI -5580美元至3598美元）。如果决策者不愿意为功能或自杀倾向的任何改善付费，从治疗医院的角度来看，快速反应小组有95%的概率具有成本效益。从社会角度来看，该干预措施在功能方面具有成本效益的概率约为70%，在自杀倾向方面为63%。两种观点之间的差异主要归因于治疗医院以外的住院费用。
从治疗医院的角度来看，与常规护理相比，快速反应小组干预似乎具有成本效益，但从社会角度来看没有差异。
