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单次即走式咨询的成本效益分析。

Cost-effectiveness analysis of single-session walk-in counselling.

机构信息

a School of Public Policy, University of Calgary , Calgary , AB , Canada.

b Faculty of Social Work , Wilfrid Laurier University , Kitchener , ON , Canada.

出版信息

J Ment Health. 2018 Dec;27(6):560-566. doi: 10.1080/09638237.2017.1340619. Epub 2017 Jul 4.

Abstract

BACKGROUND

An increasing number of family service agencies and community-based mental health service providers are implementing a single-session walk-in counselling (SSWIC) as an alternative to traditional counselling. However, few economic evaluations have been undertaken.

AIMS

To conduct a cost-effectiveness analysis of two models of service delivery, SSWIC compared to being waitlisted for traditional counselling.

METHODS

A quasi-experimental design was employed. Data were collected from two community-based Family Service Agencies, one using SSWIC and one using traditional counselling. Participants were assessed at baseline and four weeks after the baseline. Cost-effectiveness was estimated from the societal and payer's perspective.

RESULTS

The societal and payer's costs for SSWIC were higher than for those waiting for traditional counselling, and health outcomes were better. SSWIC is not cost-effective compared to being on the waitlist for traditional counselling (or, for a few patients, having received counselling, but after a wait of several weeks).

CONCLUSIONS

SSWIC has the potential to reduce the pressure on the mental health care system by reducing emergency visits and wait lists for ongoing mental health services and eliminating costly-no shows at counselling appointments. Long-term studies involving multiple walk-in counselling services and comparison services are needed to support the findings of this study.

摘要

背景

越来越多的家庭服务机构和社区心理健康服务提供商正在实施单次就诊咨询(SSWIC)作为传统咨询的替代方案。然而,很少有经济评估。

目的

对两种服务提供模式(SSWIC 与传统咨询的候补名单)进行成本效益分析。

方法

采用准实验设计。数据来自两家社区家庭服务机构,一家使用 SSWIC,一家使用传统咨询。参与者在基线和基线后四周进行评估。从社会和支付者的角度估算成本效益。

结果

SSWIC 的社会和支付者成本高于传统咨询候补名单的成本,且健康结果更好。与传统咨询候补名单相比,SSWIC 不具有成本效益(对于少数患者,在等待数周后接受了咨询,但成本效益不佳)。

结论

SSWIC 通过减少对紧急心理健康服务的需求和候补名单,以及消除咨询预约时昂贵的爽约现象,有可能减轻心理健康护理系统的压力。需要进行长期研究,涉及多个单次就诊咨询服务和比较服务,以支持本研究的结果。

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