Kurisu Ken, Nohara Nobuhiro, Inada Shuji, Otani Makoto, Noguchi Haruko, Endo Yuka, Sato Yasuhiro, Fukudo Shin, Nakazato Michiko, Yamauchi Tsuneo, Harada Tomoko, Inoue Koki, Hata Tomokazu, Takakura Shu, Sudo Nobuyuki, Iida Naoko, Mizuhara Yuki, Wada Yoshihisa, Ando Tetsuya, Yoshiuchi Kazuhiro
Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
Department of Psychosomatic Medicine, Kindai University Hospital, Osaka, Japan.
J Eat Disord. 2023 Aug 14;11(1):136. doi: 10.1186/s40337-023-00864-2.
Few studies have examined the economic costs of outpatient care for eating disorders in Japan. This study aimed to clarify the reimbursement for outpatient treatment of eating disorders and compare the costs between the departments of Psychosomatic Medicine and Psychiatry in Japan.
A multicenter, prospective, observational study of patients with an eating disorder was conducted in the Psychosomatic Medicine departments of three centers and the Psychiatry departments of another three centers in Japan. We analyzed medical reimbursement for an outpatient revisit, time of clinical interviews, and the treatment outcome measured by the Eating Disorder Examination Questionnaire (EDE-Q) global scores and body mass index (BMI) at 3 months. Multivariate linear regression models were performed to adjust for covariates.
This study included 188 patients in the Psychosomatic Medicine departments and 68 in the Psychiatry departments. The average reimbursement cost for an outpatient revisit was 4670 yen. Even after controlling for covariates, the Psychosomatic Medicine departments had lower reimbursement points per minute of interviews than the Psychiatry departments (coefficient = - 23.86; 95% confidence interval = - 32.09 to - 15.63; P < 0.001). In contrast, EDE-Q global scores and BMI at 3 months were not significantly different between these departments.
This study clarifies the economic costs of treating outpatients with eating disorders in Japan. The medical reimbursement points per interview minute were lower in Psychosomatic Medicine departments than in Psychiatry departments, while there were no apparent differences in the treatment outcomes. Addressing this issue is necessary to provide an adequate healthcare system for patients with eating disorders in Japan.
在日本,很少有研究探讨饮食失调门诊治疗的经济成本。本研究旨在明确饮食失调门诊治疗的报销情况,并比较日本心身医学科和精神科之间的成本。
在日本三个中心的心身医学科和另外三个中心的精神科对饮食失调患者进行了一项多中心、前瞻性观察研究。我们分析了门诊复诊的医疗报销情况、临床访谈时间,以及通过饮食失调检查问卷(EDE-Q)全球评分和3个月时的体重指数(BMI)衡量的治疗结果。采用多元线性回归模型对协变量进行调整。
本研究纳入了188名心身医学科患者和68名精神科患者。门诊复诊的平均报销费用为4670日元。即使在控制协变量后,心身医学科每分钟访谈的报销点数仍低于精神科(系数 = -23.86;95%置信区间 = -32.09至-15.63;P < 0.001)。相比之下,这些科室在3个月时的EDE-Q全球评分和BMI没有显著差异。
本研究明确了日本饮食失调门诊患者的治疗经济成本。心身医学科每次访谈分钟的医疗报销点数低于精神科,而治疗结果没有明显差异。解决这一问题对于为日本饮食失调患者提供适当的医疗保健系统是必要的。