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[针对回避上学的患有精神疾病儿童的基于手册的多模式认知行为疗法的经济学评估]

[Economic evaluation of a manual-based, multimodal cognitive behavioural therapy for school avoiding children with psychiatric disorder].

作者信息

Weschenfelder Ann-Kathrin, Reissner Volker, Knollmann Martin, Hebebrand Johannes, Wasem Jürgen, Neumann Anja

机构信息

1 Lehrstuhl für Medizinmanagement, Universität Duisburg-Essen.

a Beide Autoren trugen im gleichen Maße zu der Untersuchung bei.

出版信息

Z Kinder Jugendpsychiatr Psychother. 2018 Jan;46(1):47-56. doi: 10.1024/1422-4917/a000501. Epub 2017 Jan 24.

Abstract

OBJECTIVE

Untreated school refusal increases the risk of a premature discontinuation of the educational career. The aim of this study is the economic evaluation of a manual-based treatment for school refusal in comparison to the standard treatment.

METHOD

Within the cost-minimisation analysis, resource use is measured retrospectively for six months using the CSSRI questionnaire. Unit costs for most health care services are derived from published standard prices. Costs are calculated from the societal perspective based on prices compiled in 2011. The cost comparison during the one-year intervention period applies a difference in differences Approach.

RESULTS

The most common diagnoses among the 112 participants are phobic and emotional disorders. The average cost per patient during the intervention period amounts to 7197 € (95 %-CI: 4746 € – 10 079 €) for the manual group and 9294 € (95 %-CI: 6313 € – 12 878 €) for the control group. The difference in adjusted costs of 1453 € in favour of the manual group is not statistically relevant.

CONCLUSIONS

The manual-based treatment is equivalent if not slightly advantageous compared to the standard treatment considering the clinical outcomes and cost of illness.

摘要

目的

未经治疗的学校拒学症会增加过早中断学业的风险。本研究的目的是对一种基于手册的学校拒学症治疗方法与标准治疗方法进行经济学评估。

方法

在成本最小化分析中,使用CSSRI问卷对资源使用情况进行为期六个月的回顾性测量。大多数医疗服务的单位成本来自已公布的标准价格。成本是从社会角度根据2011年编制的价格计算得出的。一年干预期内的成本比较采用双重差分法。

结果

112名参与者中最常见的诊断是恐惧症和情绪障碍。干预期间,手册组每名患者的平均成本为7197欧元(95%置信区间:4746欧元 - 10079欧元),对照组为9294欧元(95%置信区间:6313欧元 - 12878欧元)。手册组调整后成本比对照组低1453欧元,这一差异无统计学意义。

结论

考虑到临床结果和疾病成本,基于手册的治疗方法即便没有略微优势,至少也与标准治疗方法相当。

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