Psychosis Clinical Academic Group and Public Mental Health, South London and Maudsley NHS Foundation Trust, London, UK.
Faculty of Brain Sciences, University College London, London, UK.
Early Interv Psychiatry. 2019 Dec;13(6):1424-1430. doi: 10.1111/eip.12787. Epub 2019 Feb 10.
Early Intervention Psychosis Services (EIPS) for people experiencing First Episode Psychosis (FEP) offer important clinical and non-clinical benefits over standard care. Similarly, intervention for Clinical High Risk for Psychosis state (CHR-P) can prevent psychosis, ameliorate symptoms and have non-clinical benefits. This study aimed to estimate associated local economic benefits of FEP and CHR-P services compared with standard care.
Across four south London boroughs, proportion of annual number of new cases of FEP and CHR-P seen by early intervention services was estimated. Economic modelling conducted for England's mental health strategy was applied to estimate local economic impacts of current and improved service provision.
Across four London boroughs during 2011/2012, proportion of 15-34 year olds with FEP seen by EIPS was 100.2% assuming 80/100 000 annual incidence whereas proportion with CHR-P seen by CHR-P services was 4.1% assuming 200/100 000 annual incidence. Application of economic modelling suggests that provision of EIPS to reach all new FEP cases each year would free up resources of £13.1m over 10 years including £2.0m to National Health Service (NHS) after the first year. Scaling up to reach all new CHR-P cases each year would free up resources of £19.7m over 10 years with an estimated 10-year cost of implementation gap for each 1 year cohort of £18.9m. An earlier related briefing resulted in increased funding for EIPS and new CHR-P services despite overall cuts to mental health services.
Estimation of local economic impacts of FEP and CHR-P services was associated with improved investment in such services.
与标准护理相比，为首发精神病（FEP）患者提供早期精神病干预服务（EIPS）具有重要的临床和非临床益处。同样，对精神病高危（CHR-P）状态的干预也可以预防精神病，减轻症状，并带来非临床益处。本研究旨在估计 FEP 和 CHR-P 服务与标准护理相比的相关地方经济效益。
在四个伦敦南部行政区，估计了通过早期干预服务看到的新 FEP 和 CHR-P 年度病例数的比例。应用英格兰精神卫生战略的经济模型来估计当前和改进服务提供的地方经济影响。
在 2011/2012 年的四个伦敦行政区中，假设 FEP 的年发病率为 80/100,000，EIPS 看到的 15-34 岁 FEP 患者比例为 100.2%；假设 CHR-P 的年发病率为 200/100,000，CHR-P 服务看到的 CHR-P 患者比例为 4.1%。经济模型的应用表明，每年为所有新的 FEP 病例提供 EIPS 将在 10 年内释放 1310 万英镑的资源，包括 NHS 在第一年的 200 万英镑。扩大规模以每年为所有新的 CHR-P 病例提供服务将在 10 年内释放 1970 万英镑的资源，估计每个 1 年队列的实施差距为 1890 万英镑。较早的一份相关简报导致 EIPS 和新的 CHR-P 服务获得了更多的资金，尽管整体上削减了精神卫生服务。
FEP 和 CHR-P 服务的地方经济效益估计与对这些服务的改善投资有关。
