McGregor K, Pentland B
Lothian Clinical Audit, Edinburgh, U.K.
Soc Sci Med. 1997 Jul;45(2):295-303. doi: 10.1016/s0277-9536(96)00345-0.
The human and societal costs as a result of traumatic brain injury (TBI) are extensive with approximately 200-300/100,000 of the population requiring hospitalisation each year in the U.K. Advances in neurosurgical management have meant that more people sustaining head injuries are surviving. The need for rehabilitation programmes for these individuals is therefore ever increasing. While in the U.S.A. rehabilitation programmes for TBI patients are well established, in the U.K. the provision of such services is patchy and varies widely in different localities. The belated response to the rehabilitation needs of this group of individuals in the U.K. has coincided with an increased awareness of the economic efficiency of health care provision. This paper critically reviews published studies looking at the economics of rehabilitation services for brain injured patients. No studies in the U.K. were identified and all the sources discussed are from the U.S.A. The methodological guidelines underlying economic appraisal of health care are summarised and the studies assessed to determine the extent to which they fulfil these guidelines. The paper concludes that most studies purporting to provide evidence of cost-effectiveness did not include appropriate data, nor followed the methodological guidelines allowing such claims to be made. Some recommendations for future research are presented.
创伤性脑损伤（TBI）造成的人力和社会成本巨大，在英国，每年每10万人中约有200 - 300人需要住院治疗。神经外科治疗技术的进步意味着更多头部受伤的人得以存活。因此，为这些人提供康复计划的需求日益增加。在美国，针对TBI患者的康复计划已很成熟，但在英国，此类服务的提供情况参差不齐，不同地区差异很大。英国对这部分人群康复需求的迟缓回应，恰逢人们对医疗保健提供的经济效率的认识有所提高。本文批判性地回顾了已发表的关于脑损伤患者康复服务经济学的研究。未找到英国的相关研究，所讨论的所有资料均来自美国。总结了医疗保健经济评估的方法指南，并对这些研究进行评估，以确定它们在多大程度上符合这些指南。本文的结论是，大多数声称提供成本效益证据的研究既没有纳入适当的数据，也未遵循允许做出此类断言的方法指南。文中还提出了一些对未来研究的建议。
