Cantor J C, Morisky D E, Green L W, Levine D M, Salkever D S
Prev Med. 1985 Nov;14(6):782-800. doi: 10.1016/0091-7435(85)90071-4.
To examine the relative cost-effectiveness of single versus multiple patient education strategies to reduce hypertension, we assigned patients to seven intervention groups and to a usual-care control group using a randomized factorial design. We compared cost-effectiveness measures for single, double, and triple combinations of (a) a clinic exit interview with patients to clarify their medical regimens, (b) an educational meeting with a member of the patient's family to aid in management at home, and (c) a series of small group sessions to help patients overcome personal barriers to management. We observed consistent results for six different effectiveness measures under a variety of decision-making rules. Our results suggest that in the absence of targeting of multiple interventions to systematically selected high-risk patients, multiple intervention combinations are not more cost-effective than single interventions.
为研究单种与多种患者教育策略降低高血压的相对成本效益，我们采用随机析因设计，将患者分配至七个干预组和一个常规护理对照组。我们比较了以下三种措施单种、两种及三种组合的成本效益：(a) 与患者进行门诊出院面谈以阐明其治疗方案；(b) 与患者家属举行一次教育会议以协助家庭管理；(c) 开展一系列小组会议以帮助患者克服管理方面的个人障碍。在各种决策规则下，我们针对六种不同的有效性指标观察到了一致的结果。我们的结果表明，在未针对系统选择的高危患者进行多种干预的情况下，多种干预组合并不比单种干预更具成本效益。
