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对Kooth的早期经济评估,Kooth是一个为有心理健康需求的儿童和年轻人提供的基于网络的心理健康平台。

An early economic evaluation of Kooth, a web-based mental health platform for children and young people with emerging mental health needs.

作者信息

Coote Laura, Kelly Laura, Graham Charlotte, Curtis-Gretton Luc, Green Maisie, Salhi Louisa, de Ossorno Garcia Santiago, Sefi Aaron, Holmes Hayden

机构信息

York Health Economics Consortium, Enterprise House, Innovation Way, University of York, Heslington, York YO10 5NQ, UK.

Kooth Digital Health, 5 Merchant Square, London W2 1AY, UK.

出版信息

Internet Interv. 2024 May 11;36:100748. doi: 10.1016/j.invent.2024.100748. eCollection 2024 Jun.

Abstract

BACKGROUND

"Kooth" is a web-based mental health platform commissioned by the National Health Service (NHS), local authorities, charities, and businesses in the UK. The platform gives children and young people (CYP) access to an online community of peers and a team of counsellors. This study reports an early economic evaluation of the potential benefits of Kooth in the UK.

METHODS

An early evidence cost calculator was built to estimate the potential costs and savings of implementing Kooth from a UK NHS and crime sector perspective. A decision tree structure was used to track the progress of CYP with emerging mental health needs (EMHN), comparing CYP with access to Kooth to CYP without access to Kooth. The model implemented a 12-month time horizon and followed a typical Kooth contract in relation to costing, engagement, and CYP demographics.

RESULTS

The base case results followed a cohort of 2160 CYP. The results of the cost calculator estimated that engagement with Kooth is associated with a cost saving of £469,237 to the NHS across a 12-month time horizon, or £236.15 per CYP with an EMHN. From a combined NHS and UK crime sector perspective, the cost savings increased to £489,897, or £246.54 per CYP with an EMHN. The largest cost savings were provided by an estimated reduction of 5346 GP appointments and 298 antidepressant prescriptions. For this cohort, the model predicted that engagement with Kooth averted 6 hospitalisations due to suicidal ideation and 13 hospitalisations due to self-harm. Furthermore, the number of smokers and binge drinkers was reduced by 20 and 24, respectively. When a crime sector perspective was taken, 3 crimes were averted.

DISCUSSION

This early model demonstrates that Kooth has the potential to be a cost-saving intervention from both an NHS and a combined NHS and UK crime sector perspective. Cost savings were provided through aversion in clinical and social outcomes. The model used a conservative approach to balance the uncertainty around assumptions of the intermediate outcomes (GP and medication use). However, it is limited by a paucity of costing data and published evidence relating to the impact of digital mental health platforms.

摘要

背景

“Kooth”是一个基于网络的心理健康平台,由英国国家医疗服务体系(NHS)、地方当局、慈善机构和企业委托设立。该平台为儿童和青少年提供了一个在线同龄人社区以及一支咨询师团队。本研究报告了Kooth在英国潜在益处的早期经济评估。

方法

构建了一个早期证据成本计算器,从英国NHS和犯罪部门的角度估算实施Kooth的潜在成本和节省情况。采用决策树结构来跟踪有新发心理健康需求(EMHN)的儿童和青少年的进展,将能够使用Kooth的儿童和青少年与无法使用Kooth的儿童和青少年进行比较。该模型设定了12个月的时间范围,并遵循了一份关于成本核算、参与情况和儿童及青少年人口统计学特征的典型Kooth合同。

结果

基础案例结果跟踪了2160名有新发心理健康需求的儿童和青少年。成本计算器的结果估计,在12个月的时间范围内,与Kooth的接触为NHS节省了469,237英镑的成本,即每名有新发心理健康需求的儿童和青少年节省236.15英镑。从NHS和英国犯罪部门的综合角度来看,成本节省增加到489,897英镑,即每名有新发心理健康需求的儿童和青少年节省246.54英镑。最大的成本节省来自预计减少5346次全科医生预约和298份抗抑郁药处方。对于这个队列,该模型预测与Kooth的接触避免了6起因自杀意念导致的住院和13起因自残导致的住院。此外,吸烟者和酗酒者的数量分别减少了20人和24人。从犯罪部门的角度来看,避免了3起犯罪。

讨论

这个早期模型表明,从NHS以及NHS和英国犯罪部门的综合角度来看,Kooth都有可能成为一种节省成本的干预措施。通过避免临床和社会结果方面的问题实现了成本节省。该模型采用了一种保守的方法来平衡中间结果(全科医生就诊和药物使用)假设的不确定性。然而,它受到成本核算数据匮乏以及与数字心理健康平台影响相关的已发表证据不足的限制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f195/11129085/0518eae81814/gr1.jpg

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