移动医疗与基于诊所的严重精神疾病护理的成本：相同效果，一半价格。
Cost of mHealth Versus Clinic-Based Care for Serious Mental Illness: Same Effects, Half the Price Tag.
机构信息
BRiTE (Behavioral Research in Technology and Engineering) Center, Department of Psychiatry and Behavioral Sciences (Ben-Zeev), and Department of Global Health (Levin), University of Washington, Seattle; Center on Mental Health Services Research and Policy, Department of Psychiatry, University of Illinois at Chicago, Chicago (Razzano); Thresholds Inc., Chicago (Razzano, Pashka).
出版信息
Psychiatr Serv. 2021 Apr 1;72(4):448-451. doi: 10.1176/appi.ps.202000349. Epub 2021 Feb 9.
OBJECTIVE
This study compared the costs of implementing a smartphone-delivered mobile health (mHealth) intervention (called FOCUS) with the costs of implementing a clinic-based group intervention (Wellness Recovery Action Planning [WRAP]) for serious mental illness. Treatments were delivered in parallel in a randomized controlled trial and produced comparable clinical outcomes.
METHODS
Retrospective cost data were collected by using mixed-methods, top-down expenditure analysis with microcosting procedures. Costs were organized by input categories, including personnel, supplies, equipment, overhead, and indirect costs. All estimates are reported in US$.
RESULTS
The average annual cost to providers was $78,212 for WRAP and $40,439 for FOCUS. In both groups, labor accounted for the largest cost, followed by indirect costs and overhead costs. When indirect costs were excluded, WRAP cost $520 per client per month, compared with $256 for FOCUS.
CONCLUSIONS
mHealth produced the same patient outcomes as clinic-based group treatment at approximately half the cost.
目的
本研究比较了实施智能手机为媒介的移动医疗（mHealth）干预（称为 FOCUS）的成本与实施以诊所为基础的团体干预（心理健康康复行动计划[WRAP]）的成本，用于治疗严重精神疾病。这两种治疗方法在随机对照试验中并行实施，产生了可比的临床效果。
方法
采用混合方法、自上而下的支出分析与微观成本核算程序，收集回顾性成本数据。成本按投入类别进行组织，包括人员、用品、设备、间接成本和间接成本。所有估计均以美元报告。
结果
WRAP 的平均年度提供者成本为 78212 美元，FOCUS 为 40439 美元。在这两个组中，劳动力成本最高，其次是间接成本和间接费用。当排除间接成本时，WRAP 的每个客户每月成本为 520 美元，而 FOCUS 为 256 美元。
结论
mHealth 产生了与以诊所为基础的团体治疗相同的患者结果，但成本约为其一半。
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