Center for Psychotherapy Research, University Hospital Heidelberg, Heidelberg, Germany.
Int J Eat Disord. 2017 Dec;50(12):1378-1384. doi: 10.1002/eat.22792. Epub 2017 Oct 27.
Although effective interventions for eating disorders (ED) are available, the impact of health care services on a population level is far from satisfactory. A mathematical model of how health care for ED affects the population's disease burden can stimulate discussions and provide guidance about promising strategies to reduce ED-related suffering on the population level.
The current health care situation for ED is modeled taking into account the reach and effectiveness of prevention, treatment, and aftercare, as well as incidence rates, relapse rates, and rates for spontaneous remissions. A first-order Markov model is applied and the effect of changes in single service parameters on the populations overall disease burden are simulated.
Improvements of treatment utilization and the reach of prevention programs would have the largest effects on the population's disease burden. Improving the efficacy of treatment, prevention, and aftercare show only limited effects.
In order to maximize the public health impact of health care for ED new models of treatment delivery as well as public health approaches to the prevention of ED are critical.
尽管已有针对饮食失调症（ED）的有效干预措施，但医疗保健服务对人群的影响远不尽如人意。建立一个关于医疗保健如何影响人群疾病负担的数学模型，可以激发关于减少人群中 ED 相关痛苦的有前景的策略的讨论，并提供指导。
本研究通过考虑预防、治疗和康复的可及性和有效性，以及发病率、复发率和自发缓解率，对 ED 的当前医疗保健状况进行建模。应用一阶马尔可夫模型模拟单个服务参数变化对人群整体疾病负担的影响。
提高治疗利用率和预防计划的可及性将对人群的疾病负担产生最大影响。提高治疗、预防和康复的疗效仅显示出有限的效果。
为了最大限度地提高 ED 医疗保健的公共卫生影响，新的治疗提供模式以及 ED 预防的公共卫生方法至关重要。
