Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, 89312 Günzburg, Germany.
Institute of Epidemiology and Medical Biometry, Ulm University, 89075 Ulm, Germany.
Int J Environ Res Public Health. 2022 Jun 2;19(11):6814. doi: 10.3390/ijerph19116814.
The network for mental health (NWpG = Netzwerk psychische Gesundheit) is an umbrella association for non-medical community mental health care facilities across Germany which are enabled to provide multi-professional mental health care packages including medical and psychosocial services reimbursed by German statutory health insurances since 2009. The aim of this study is to analyse the cost-effectiveness of providing NWpG mental health care packages plus treatment as usual (NWpG) to treatment as usual alone (TAU) in Germany. In a prospective, multicenter, controlled trial over 18 months, a total of 511 patients (NWpG = 251; TAU = 260) were observed in five regions, four times at six-month intervals. The EQ-5D-3L and the Client Sociodemographic and Service Receipt Inventory (CSSRI) were used to estimate quality-adjusted life-years and total costs of illness. Propensity score-adjusted cost-utility analysis was applied using the net benefit approach. No significant differences in costs and QALYs between NWpG and TAU groups were identified. The probability of NWpG being cost-effective compared to TAU was estimated below 75% for maximum willingness to pay (MWTP) values between 0 and 125,000 EUR. The additional provision of the NWpG package is not cost-effective compared to TAU alone.
心理健康网络(NWpG=Netzwerk psychische Gesundheit)是一个伞式组织,涵盖了全德国的非医疗社区心理健康护理机构,自 2009 年以来,这些机构能够提供多专业的心理健康护理套餐,包括医疗和心理社会服务,由德国法定健康保险报销。本研究的目的是分析在德国为 NWpG 心理健康护理套餐(NWpG)提供治疗与常规治疗(TAU)相比的成本效益。在一项为期 18 个月的前瞻性、多中心、对照试验中,在五个地区观察了 511 名患者(NWpG=251;TAU=260),每六个月观察四次。使用 EQ-5D-3L 和客户社会人口统计学和服务接收清单(CSSRI)来估计调整后的生命质量和疾病总费用。采用净效益方法进行倾向评分调整后的成本效益分析。在 0 至 125,000 欧元的最大支付意愿(MWTP)值范围内,NWpG 组和 TAU 组在成本和 QALY 方面没有显著差异。与 TAU 相比,NWpG 的成本效益概率估计在 75%以下。与单独的 TAU 相比,NWpG 套餐的额外提供不具有成本效益。