一种整合家庭与学校的针对小儿注意力不集中型多动症的行为心理社会治疗方法的成本效益分析
Cost-Effectiveness of a Behavioral Psychosocial Treatment Integrated Across Home and School for Pediatric ADHD-Inattentive Type.
作者信息
Tran Jennifer L A, Sheng Rena, Beaulieu Allyson, Villodas Miguel, McBurnett Keith, Pfiffner Linda J, Wilson Leslie
机构信息
Department of Clinical Pharmacy, University of California, San Francisco, 3333 California St, Suite 420, Box 0613, San Francisco, CA, 94143, USA.
Department of Psychiatry, University of California, San Francisco, San Francisco, USA.
出版信息
Adm Policy Ment Health. 2018 Sep;45(5):741-750. doi: 10.1007/s10488-018-0857-y.
We conducted a cost-effectiveness analysis (CEA) of two behavioral psychosocial interventions for children with ADHD-inattentive type: Child Life and Attention Skills (CLAS) program and parent-focused treatment (PFT) compared to community-based treatment as usual (TAU). The CEA evaluated cost per ADHD case resolved measured by parent and teacher reports of ADHD inattentive symptoms. Total cost per patient for CLAS, PFT, and TAU were $1559, $710, and $0. CLAS, the costliest treatment, was more effective than PFT and TAU. The incremental cost-effectiveness ratios (ICER) per disordered case resolved are: $3997 for CLAS versus TAU, $3227 for PFT versus TAU, and $4994 for CLAS versus PFT. PFT is the more cost-effective option based on initial CEA. However, CLAS may be comparably cost-effective by streamlining the model, which resulted in an ICER of $29 compared to PFT. Notably, cost for CLAS is substantially below the annual cost for unresolved ADHD.
我们对注意力不集中型多动症儿童的两种行为心理社会干预措施进行了成本效益分析（CEA）：儿童生活与注意力技能（CLAS）项目和以家长为中心的治疗（PFT），并将其与常规社区治疗（TAU）进行比较。CEA评估了通过家长和教师对注意力不集中型多动症症状的报告来衡量的每解决一例多动症病例的成本。CLAS、PFT和TAU的每位患者总成本分别为1559美元、710美元和0美元。CLAS是成本最高的治疗方法，但比PFT和TAU更有效。每解决一例疾病的增量成本效益比（ICER）为：CLAS与TAU相比为3997美元，PFT与TAU相比为3227美元，CLAS与PFT相比为4994美元。根据初步的CEA，PFT是更具成本效益的选择。然而，通过简化模型，CLAS可能具有相当的成本效益，与PFT相比，其ICER为29美元。值得注意的是，CLAS的成本大幅低于未解决的多动症的年度成本。
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