创伤后科索沃战争人群共病障碍的生物-心理-社会干预的经济评价。

Economic evaluation of a bio-psycho-social intervention for comorbid disorders in a traumatized population in post-war Kosovo.

机构信息

Institue of Health and Welfare Policy, National Yang-Ming University, 112 Taipei, Taiwan ROC.

出版信息

J Rehabil Med. 2018 May 8;50(5):444-450. doi: 10.2340/16501977-2322.

DOI:10.2340/16501977-2322

PMID:29487948

Abstract

OBJECTIVE

Post-hoc economic evaluation of a bio-psycho-social intervention in post-war Kosovo from a societal perspective.

DESIGN

Cost-effectiveness analysis, cost-utility analysis, and partial cost-benefit analysis using data from a randomized controlled trial.

PATIENTS

Thirty-four torture/war victims with comorbid conditions enrolled in 2012-2013.

METHODS

Participants were randomly assigned to an "intervention" and a "waiting-list" group. Changes in mental, emotional and physical health and functional impairment were assessed before and after treatment, along with increase in labour income as a proxy for productivity gain. The cost of an extra unit of effectiveness and an additional quality-adjusted life year were calculated.

RESULTS

The total cost per participant was €1,322 including, or €1,019 excluding, research costs. Wide variations in costs of changes in mental, emotional and physical effectiveness were demonstrated. Multidisciplinary intervention resulted in functional improvement at a cost of €10,508 per quality-adjusted life year gained. With a mean monthly income increase to €133 (18%) after intervention, the intervention cost per participant would be equal to the total increase in monthly income after 4-5 years, assuming the increased level is maintained.

CONCLUSION

Socio-economic benefit associated with quality-adjusted life year gain is shown, although the cost of an additional quality-adjusted life year is above the World Health Organization cost-effectiveness threshold.

摘要

目的

从社会角度对科索沃战后一项生物-心理-社会干预的事后经济评价。

设计

成本效益分析、成本效用分析和部分成本效益分析，使用来自随机对照试验的数据。

患者

34 名患有合并症的酷刑/战争受害者，于 2012 年至 2013 年入组。

方法

参与者被随机分配到“干预”组和“等候名单”组。在治疗前后评估心理健康、情绪和身体健康以及劳动力收入（生产力提高的替代指标）的变化。计算额外单位效果和额外质量调整生命年的成本。

结果

每位参与者的总成本为 1322 欧元，包括研究成本，或不包括研究成本的 1019 欧元。精神、情绪和身体效果变化的成本存在很大差异。多学科干预以 10508 欧元/质量调整生命年的成本实现了功能改善。干预后参与者每月收入平均增加 133 欧元（18%），假设增加的水平得以维持，那么干预的每位参与者成本将等于每月收入增加 4-5 年后的总收入。