Howard-Wilsher Stephanie, Irvine Lisa, Fan Hong, Shakespeare Tom, Suhrcke Marc, Horton Simon, Poland Fiona, Hooper Lee, Song Fujian
Faculty of Medicine and Health Science, University of East Anglia, Norwich, UK.
School of Public Health, Nanjing Medical University, Nanjing, PR China.
Disabil Health J. 2016 Jan;9(1):11-25. doi: 10.1016/j.dhjo.2015.08.009. Epub 2015 Sep 14.
Health related rehabilitation is instrumental in improving functioning and promoting participation by people with disabilities. To make clinical and policy decisions about health-related rehabilitation, resource allocation and cost issues need to be considered.
To provide an overview of systematic reviews (SRs) on economic evaluations of health-related rehabilitation.
We searched multiple databases to identify relevant SRs of economic evaluations of health-related rehabilitation. Review quality was assessed by AMSTAR checklist.
We included 64 SRs, most of which included economic evaluations alongside randomized controlled trials (RCTs). The review quality was low to moderate (AMSTAR score 5-8) in 35, and high (score 9-11) in 29 of the included SRs. The included SRs addressed various health conditions, including spinal or other pain conditions (n = 14), age-related problems (11), stroke (7), musculoskeletal disorders (6), heart diseases (4), pulmonary (3), mental health problems (3), and injury (3). Physiotherapy was the most commonly evaluated rehabilitation intervention in the included SRs (n = 24). Other commonly evaluated interventions included multidisciplinary programmes (14); behavioral, educational or psychological interventions (11); home-based interventions (11); complementary therapy (6); self-management (6); and occupational therapy (4).
Although the available evidence is often described as limited, inconsistent or inconclusive, some rehabilitation interventions were cost-effective or showed cost-saving in a variety of disability conditions. Available evidence comes predominantly from high income countries, therefore economic evaluations of health-related rehabilitation are urgently required in less resourced settings.
与健康相关的康复对于改善残疾人士的功能及促进其参与至关重要。为了做出有关与健康相关康复的临床和政策决策，需要考虑资源分配和成本问题。
概述有关与健康相关康复的经济评估的系统评价（SR）。
我们检索了多个数据库，以识别有关与健康相关康复的经济评估的相关SR。通过AMSTAR清单评估综述质量。
我们纳入了64项SR，其中大多数在随机对照试验（RCT）的同时纳入了经济评估。在所纳入的SR中，35项的综述质量为低至中等（AMSTAR评分5-8），29项为高（评分9-11）。所纳入的SR涉及各种健康状况，包括脊柱或其他疼痛状况（n = 14）、与年龄相关的问题（11）、中风（7）、肌肉骨骼疾病（6）、心脏病（4）、肺部疾病（3）、心理健康问题（3）和损伤（3）。物理治疗是所纳入的SR中最常评估的康复干预措施（n = 24）。其他常评估的干预措施包括多学科项目（14）；行为、教育或心理干预（11）；家庭干预（11）；补充疗法（6）；自我管理（6）；和职业治疗（4）。
尽管现有证据通常被描述为有限、不一致或无定论，但一些康复干预措施在各种残疾状况下具有成本效益或显示出成本节约。现有证据主要来自高收入国家，因此资源较少的环境迫切需要对与健康相关的康复进行经济评估。
