Beecham Jennifer, Bonin Eva-Maria, Görlich Dennis, Baños Rosa, Beintner Ina, Buntrock Claudia, Bolinski Felix, Botella Cristina, Ebert David Daniel, Herrero Rocio, Potterton Rachel, Riper Heleen, Schmidt Ulrike, Waldherr Karin, Weisel Kiona, Zarski Anna-Carlotta, Zeiler Michael, Jacobi Corinna
Personal Social Services Research Unit, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, UK.
Personal Social Services Research Unit, University of Kent, Canterbury, UK.
Internet Interv. 2018 Feb 27;16:12-19. doi: 10.1016/j.invent.2018.02.009. eCollection 2019 Apr.
Mental health problems are common and place a burden on the individual as well as on societal resources. Despite the existence of evidence-based treatments, access to treatment is often prevented or delayed due to insufficient health care resources. Effective internet-based self-help interventions have the potential to reduce the risk for mental health problems, to successfully bridge waiting time for face-to-face treatment and to address inequities in access. However, little is known about the cost-effectiveness of such interventions. This paper describes the study protocol for the economic evaluation of the studies that form the ICare programme of internet-based interventions for the prevention and treatment of a range of mental health problems.
An overarching work package within the ICare programme was developed to assess the cost-effectiveness of the internet-based interventions alongside the clinical trials. There are two underlying tasks in the ICare economic evaluation. First, to develop schedules that generate equivalent and comparable information on use of services and supports across seven countries taking part in clinical trials of different interventions and second, to estimate unit costs for each service and support used. From these data the cost per person will be estimated by multiplying each participant's use of each service by the unit cost for that service. Additionally, productivity losses will be estimated. This individual level of cost data matches the level of outcome data used in the clinical trials. Following the analyses of service use and costs data, joint analysis of costs and outcomes will be undertaken to provide findings on the relative cost-effectiveness of the interventions, taking both a public sector and a societal perspective. These analyses use a well-established framework, the Production of Welfare approach, and standard methods and techniques underpinned by economic theory.
DISCUSSION/CONCLUSION: Existing research tends to support the effectiveness of internet-based interventions, but there is little information on their cost-effectiveness compared to 'treatment as usual'. The economic evaluation of ICare interventions will add considerably to this evidence base.
心理健康问题很常见，给个人以及社会资源都带来了负担。尽管存在循证治疗方法，但由于医疗资源不足，往往无法获得或延迟治疗。有效的基于互联网的自助干预措施有可能降低心理健康问题的风险，成功缩短面对面治疗的等待时间，并解决治疗可及性方面的不平等问题。然而，对于此类干预措施的成本效益知之甚少。本文描述了对一系列基于互联网的预防和治疗心理健康问题的干预措施所构成的“关爱计划”（ICare programme）进行经济评估的研究方案。
在“关爱计划”中制定了一个总体工作包，以便在临床试验的同时评估基于互联网的干预措施的成本效益。“关爱计划”经济评估中有两项基本任务。第一，制定时间表，以便在参与不同干预措施临床试验的七个国家中生成关于服务和支持使用情况的等效且可比信息；第二，估算每项使用的服务和支持的单位成本。根据这些数据，通过将每个参与者对每项服务的使用量乘以该服务的单位成本来估算人均成本。此外，还将估算生产力损失。这种个体层面的成本数据与临床试验中使用的结果数据层面相匹配。在对服务使用和成本数据进行分析之后，将对成本和结果进行联合分析，从公共部门和社会角度提供关于干预措施相对成本效益的结果。这些分析采用一个成熟的框架——福利生产方法，以及以经济理论为基础的标准方法和技术。
讨论/结论：现有研究倾向于支持基于互联网的干预措施的有效性，但与“常规治疗”相比，关于其成本效益的信息很少。“关爱计划”干预措施的经济评估将大大增加这一证据基础。
