Psychiatric Research Unit, Region Zealand, Slagelse, Denmark.
Copenhagen Mental Health Centre, University of Copenhagen, Copenhagen, Denmark.
Early Interv Psychiatry. 2019 Oct;13(5):1056-1061. doi: 10.1111/eip.12727. Epub 2018 Aug 22.
Coupling data on future resource consumption with baseline characteristics can provide vital information of future consumption patterns for newly diagnosed patients. This study tested whether higher need (as measured by severity of illness) and other baseline characteristics of newly diagnosed patients were associated with higher future service costs.
Five hundred forty-seven patients between 18 and 45 years randomized to the OPUS trial was analysed in the study. Multiple regression analysis was applied to estimate the impact of the explanatory variables on mean total costs, which consisted of total health care costs and costs of supportive living facilities.
Lower age, higher level of symptoms (global assessment of functioning), alcohol or cannabis misuse, and being homeless were associated with higher total costs over 5 years, whereas sex, duration of untreated psychosis, and educational level did not show any impact on future resource consumption.
The association between future costs and severity of illness suggests that higher needs among patients were associated with higher resource input level. Our results also indicate that other factors than need might affect future costs, for example, parents who serve as advocates for young patients had impact on future health costs. We also found indications of potential barriers among patients with other citizenship in access to health-care services. The strength of the study is that resource data were extracted from official Danish registers and interviewers collected information on clinical characteristics. The results are likely to be context-specific but can be generalized to settings with similar treatment practices.
将未来资源消耗数据与基线特征相结合，可以为新诊断患者的未来消费模式提供重要信息。本研究旨在测试新诊断患者的更高需求（通过疾病严重程度衡量）和其他基线特征是否与更高的未来服务成本相关。
对 OPUS 试验中 547 名 18 至 45 岁的随机分组患者进行了分析。采用多元回归分析来估计解释变量对平均总费用（包括总医疗保健费用和支持性生活设施费用）的影响。
年龄较低、症状水平较高（整体功能评估）、酒精或大麻滥用以及无家可归与 5 年内的总费用较高相关，而性别、未治疗精神病的持续时间和教育水平对未来资源消耗没有任何影响。
未来成本与疾病严重程度之间的关联表明，患者的需求较高与资源投入水平较高相关。我们的研究结果还表明，除了需求之外，其他因素也可能影响未来的成本，例如，为年轻患者提供支持的父母会对未来的健康成本产生影响。我们还发现，其他公民在获得医疗保健服务方面存在潜在障碍的迹象。该研究的优势在于资源数据是从丹麦官方登记处提取的，访谈者收集了临床特征的信息。研究结果可能具有特定背景，但可以推广到具有类似治疗实践的环境中。
