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在澳大利亚卫生环境下实施基于证据的痴呆症护理计划:成本效益分析。

Implementing an evidence-based dementia care program in the Australian health context: A cost-benefit analysis.

机构信息

Department of Rehabilitation, Aged and Palliative Care, College of Medicine and Public Health, Flinders University, Flinders Drive Bedford Park, SA, Australia.

Cognitive Decline Partnership Centre, Hornsby Ku-ring-gai Hospital, Hornsby, NSW, Australia.

出版信息

Health Soc Care Community. 2020 Nov;28(6):2013-2024. doi: 10.1111/hsc.13013. Epub 2020 May 19.

Abstract

The World Health Organisation has called for the implementation of evidence-based interventions that enhance function and capability in people with dementia. In response, the Boosting Dementia Research Initiative in Australia has funded a number of projects aimed at improving such outcomes for people with dementia and their caregivers. What is not known is the economic and societal outcomes of these projects and of program implementation to the Australian healthcare system. The purpose of this study was to identify the costs and benefits of implementing an evidence-based reablement program within Australian health context. A well-used methodology familiar to governments and decision-makers was used to calculate the costs and benefits of implementing the program in Australia. Four different perspectives: market, private, efficiency (social) and referent group (key stakeholders) were considered in the cost-benefit evaluation. Almost A$6.2 million societal gain is presented through a social cost-benefit analysis. The referent (stakeholder) group analysis is used to demonstrate that people with dementia and their caregivers are the bearers of the costs and the Australian health and social care system gains the most from the program implementation. The results of this cost-benefit analysis suggest that there is a need to plan and provide subsidies or other financial incentives to assist people with dementia and their caregivers to engage in reablement programs in Australia; thus the whole society can be advantaged. Funding bodies and decision-makers are urged to recognise the potential societal benefits that can be achieved from participating in such reablement programs.

摘要

世界卫生组织呼吁实施基于证据的干预措施,以增强痴呆症患者的功能和能力。作为回应,澳大利亚的“增强痴呆症研究倡议”资助了多个旨在改善痴呆症患者及其护理人员相关结果的项目。但目前尚不清楚这些项目以及为澳大利亚医疗保健系统实施的项目规划会带来哪些经济和社会效益。本研究旨在确定在澳大利亚卫生背景下实施基于证据的康复计划的成本和收益。本研究采用一种为政府和决策者所熟知的常用方法,来计算在澳大利亚实施该计划的成本和收益。在成本效益评估中考虑了四种不同的视角:市场、私人、效率(社会)和参照群体(主要利益相关者)。通过社会成本效益分析,呈现了近 620 万澳元的社会收益。参照(利益相关者)群体分析用于表明痴呆症患者及其护理人员是成本的承担者,而澳大利亚的卫生和社会保健系统从项目实施中获益最多。这项成本效益分析的结果表明,有必要规划并提供补贴或其他财政激励措施,以帮助澳大利亚的痴呆症患者及其护理人员参与康复计划;从而使整个社会受益。敦促供资机构和决策者认识到参与此类康复计划可以实现的潜在社会效益。

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