Saha Sanjib, Bejerholm Ulrika, Gerdtham Ulf-G, Jarl Johan
a Health Economics Unit, Department of Clinical Science (Malmö) , Lund University , Lund , Sweden.
b Health Economics & Management , Institute of Economic Research, Lund University , Lund , Sweden.
Nord J Psychiatry. 2018 Apr;72(3):236-239. doi: 10.1080/08039488.2017.1422801. Epub 2018 Jan 9.
The individual enabling and support (IES) model was effective in gaining competitive employment for people with affective disorders compared with traditional vocational rehabilitation (TVR) services in a randomized controlled trial in a Swedish setting. The object of this study is to perform a cost-effectiveness analysis of IES comparing to TVR.
We considered the costs of intervention and productivity gain due to increased competitive employment. We estimated quality of life using EuroQol 5 Dimension (EQ-5D) and Manchester Short Assessment of Quality of Life (MANSA) scale. EQ-5D was translated into quality-adjusted life-years (QALY), using the UK, Danish, and Swedish tariffs. We performed the analysis from a societal perspective with a one-year timeframe.
The cost of IES was €7247 lower per person per year (2014 prices) compared to TVR. There were no significant differences in QALY improvement within or between groups. However, quality of life measured by the MANSA scale significantly improved over the study period in IES.
Besides the small sample size, details on the intervention costs for both IES and TVR group were unavailable and had to be obtained from external sources.
Implementation of IES for people with affective disorders is most likely cost-saving and is potentially even dominating TVR, although a larger trial is required to establish this.
在瑞典进行的一项随机对照试验中，与传统职业康复（TVR）服务相比，个体赋能与支持（IES）模式在帮助情感障碍患者获得竞争性就业方面是有效的。本研究的目的是对IES与TVR进行成本效益分析。
我们考虑了干预成本以及因竞争性就业增加而带来的生产力提升。我们使用欧洲五维健康量表（EQ-5D）和曼彻斯特生活质量简短评估量表（MANSA）来评估生活质量。EQ-5D通过英国、丹麦和瑞典的关税标准转化为质量调整生命年（QALY）。我们从社会角度进行了为期一年的分析。
与TVR相比，IES的成本为每人每年低7247欧元（2014年价格）。组内或组间在QALY改善方面没有显著差异。然而，在研究期间，通过MANSA量表测量的IES组生活质量显著改善。
除样本量小外，IES组和TVR组的干预成本细节均无法获取，必须从外部来源获得。
对情感障碍患者实施IES很可能节省成本，甚至可能优于TVR，不过还需要更大规模的试验来证实这一点。
