Neurology Service, Moisès Broggi Hospital - General Hospital of l'Hospitalet, Barcelona, Spain.
Neuroimmunology & Multiple Sclerosis, Institute of Biomedical Research of Malaga, Malaga, Spain.
BMC Health Serv Res. 2020 Feb 4;20(1):84. doi: 10.1186/s12913-020-4946-8.
Multiple Sclerosis (MS) is a chronic inflammatory, demyelinating and neurodegenerative disease that in many cases produces disability, having a high impact in patients' lives, reducing significantly their quality of life. The aim of this study was to agree on a set of proposals to improve the current management of MS within the Spanish National Health System (SNHS) and apply the Social Return on Investment (SROI) method to measure the potential social impact these proposals would create.
A Multidisciplinary Working Team of nine experts, with representation from the main stakeholders regarding MS, was set up to agree on a set of proposals to improve the management of MS. A forecast SROI analysis was carried out, with a one-year timeframe. Data sources included an expert consultation, a narrative literature review and a survey to 532 MS patients. We estimated the required investment of a hypothetical implementation, as well as the potential social value that it could create. We calculated outcomes in monetary units and we measured intangible outcomes through financial proxies.
The proposed ideal approach revealed that there are still unmet needs related to MS that can be addressed within the SNHS. Investment would amount to 148 million € and social return to 272 million €, so each euro invested could yield almost €2 of social return.
This study could guide health interventions, resulting in money savings for the SNHS and increases in patients' quality of life.
多发性硬化症（MS）是一种慢性炎症性、脱髓鞘和神经退行性疾病，在许多情况下会导致残疾，对患者的生活产生重大影响，显著降低他们的生活质量。本研究旨在就改善西班牙国家卫生系统（SNHS）内 MS 现行管理达成一系列建议，并应用社会投资回报率（SROI）方法来衡量这些建议可能产生的潜在社会影响。
成立了一个由 9 名专家组成的多学科工作组，这些专家代表了与 MS 相关的主要利益相关者，旨在就改善 MS 管理达成一系列建议。进行了预测 SROI 分析，时间框架为一年。数据来源包括专家咨询、叙述性文献综述和对 532 名 MS 患者的调查。我们估算了假设实施所需的投资，以及它可能创造的潜在社会价值。我们以货币单位衡量结果，并通过财务代理衡量无形结果。
所提出的理想方法表明，SNHS 内仍存在与 MS 相关的未满足需求，可以加以解决。投资将达到 1.48 亿欧元，社会回报为 2.72 亿欧元，因此每投资 1 欧元可获得近 2 欧元的社会回报。
本研究可以指导卫生干预措施，为 SNHS 节省资金并提高患者的生活质量。
