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德国综合性心理健康护理方案的成本效益分析。

The Cost-Effectiveness Analysis of an Integrated Mental Health Care Programme in Germany.

机构信息

Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, 89312 Günzburg, Germany.

Institute of Epidemiology and Medical Biometry, Ulm University, 89075 Ulm, Germany.

出版信息

Int J Environ Res Public Health. 2022 Jun 2;19(11):6814. doi: 10.3390/ijerph19116814.

Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cd3f/9180080/527a0f2b2546/ijerph-19-06814-g001.jpg

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