Sharif Azar E, Ravanbakhsh M, Torabipour A, Amiri E, Haghighyzade M H
Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Department of Health Services Management, School of Health, Ahvaz Jundishapor University of Medical Sciences, Ahvaz, Iran.
J Med Life. 2015;8(Spec Iss 4):245-251.
The rehabilitation services for children with cerebral palsy are provided in two forms: home-based care and center-based care. The aim of this research was to evaluate the cost-effectiveness of the home-based accordance with the center-based care for kids with cerebral palsy. In this cost-effectiveness research, 56 children under 12 years old were assigned randomly to two rehabilitation programs: (1) clinic-based rehabilitation services (CBRS); and (2) home-based rehabilitation services (HBRS). Data were collected by two questionnaires: a strong life quality survey of children with cerebral palsy (CP QOL-Child) and medical and non-medical costs' checklists. Finally, the incremental expense-efficacy rate (ICER) was used to determine the further expenses of one unit of the quality of life gained by CBRS compared with HBRS. The mean costs per patients for the home-based care group were less than the ones for the clinic-based care unit (US$ 660.3 vs. US$ 933.8). The costs of the rehabilitation services and transportation were the main costs in the two patients' groups. The quality of life for cases in the home-based care group was better than the one of the clinic-based care team. The results showed that the home-based care method was more cost-effective than the centre-based care approach in children with cerebral palsy. The incremental cost-effectiveness ratio was calculated at about US$ 2.6. The conclusion was that home-based care centers were more cost-effective than the centre-based care centers for children with cerebral palsy. Therefore, it was suggested that the health policy makers pay more attention to developing home-based care strategy in physically challenged children.
居家照护和机构照护。本研究旨在评估脑瘫患儿居家照护相对于机构照护的成本效益。在这项成本效益研究中，56名12岁以下儿童被随机分配到两个康复项目中：（1）基于诊所的康复服务（CBRS）；（2）居家康复服务（HBRS）。数据通过两份问卷收集：一份针对脑瘫患儿的生活质量强化调查问卷（CP QOL-Child）以及医疗和非医疗成本清单。最后，使用增量费用-效果比（ICER）来确定与HBRS相比，CBRS每获得一个单位生活质量所增加的费用。居家照护组每位患者的平均费用低于基于诊所的照护组（660.3美元对933.8美元）。康复服务和交通费用是两组患者的主要费用。居家照护组病例的生活质量优于基于诊所的照护组。结果表明，对于脑瘫患儿，居家照护方法比机构照护方法更具成本效益。计算得出的增量成本效益比约为2.6美元。结论是，对于脑瘫患儿，居家照护中心比机构照护中心更具成本效益。因此，建议卫生政策制定者更加关注为残疾儿童制定居家照护策略。
