Department of Medicine (DAME), University of Udine, 33100 Udine, Italy.
Central Health Directorate, Friuli Venezia Giulia Region, 34100 Trieste, Italy.
Int J Environ Res Public Health. 2020 Jul 13;17(14):5017. doi: 10.3390/ijerph17145017.
Individual Health Budget (IHB) is an intervention for recovery in mental health services, providing personalized care for subjects with severe disorders and complex needs. Little is known on its effectiveness and on the criteria for its delivery.
A total of 67 IHB beneficiaries and 61 comparators were recruited among service users of the Mental Health Department of the Trieste Healthcare Agency, Italy. Data included sociodemographic and clinical variables, type of IHB, and Health of the Nation Outcome Scale (HoNOS) scores.
A comparison between groups showed significant differences in several socioeconomic and clinical characteristics. Multivariate logistic regression showed that IHB was positively associated to the 20-49 age group, single status, unemployment, low family support, cohabitation with relatives or friends, diagnosis of personality disorder, and a higher number of hospitalizations. The IHB group was at a higher risk of severe problems related to aggressive or agitated behaviors (OR = 1.4), hallucinations and delusions (OR = 1.5), and impairment in everyday life activities (OR = 2.1).
IHB was used in patients with severe clinical and social problems. More resources, however, may be aimed at the working and social axes. More research is needed to better assess clinical and social outcomes of IHB and to adjust their intensity in a longitudinal perspective in order to enhance cost-effectiveness.
个人健康预算（IHB）是精神卫生服务中恢复的一种干预措施，为患有严重障碍和复杂需求的患者提供个性化护理。对于其有效性和实施标准知之甚少。
总共在意大利的的里雅斯特医疗保健机构的精神卫生部招募了 67 名 IHB 受益人和 61 名对照者。数据包括社会人口统计学和临床变量、IHB 的类型以及国民健康结果量表（HoNOS）评分。
组间比较显示，在几个社会经济和临床特征方面存在显著差异。多变量逻辑回归显示，IHB 与 20-49 岁年龄组、单身状态、失业、低家庭支持、与亲戚或朋友同居、人格障碍诊断以及更多住院次数呈正相关。IHB 组发生与攻击性或激越行为相关的严重问题（OR=1.4）、幻觉和妄想（OR=1.5）以及日常生活活动受损（OR=2.1）的风险更高。
IHB 用于患有严重临床和社会问题的患者。然而，可能需要更多资源针对工作和社会轴。需要进一步研究以更好地评估 IHB 的临床和社会结果，并在纵向视角下调整其强度，以提高成本效益。
