Knapp M
London School of Economics.
Br J Psychiatry. 1997 Dec;171:509-18. doi: 10.1192/bjp.171.6.509.
Schizophrenia is a common and burdensome illness, with implications not only for the health service but for a host of other care agencies--public and private--as well as for patients, families and the wider society.
The paper reviews available UK evidence on the cost of schizophrenia (broadly defined) and on the cost-effectiveness of treatment options and alternative care arrangements. New evidence potentially alters our view of the costs of this illness.
Aggregating the identifiable direct and indirect costs of schizophrenia for England suggests an annual cost of 2.6 billion pounds, but even this sum omits some indirect impacts which cannot currently be costed. Just over half the identified total is accounted for by the direct costs falling to the NHS, local authorities, charities and the criminal justice system. In helping to tackle this cost burden, there is now a body of evidence on cost-effective community care arrangements, antipsychotic drugs and psychological interventions.
Although the costs of schizophrenia are considerable, there are treatments and care arrangements which can reduce this aggregate burden while maintaining or improving effectiveness.
精神分裂症是一种常见且负担沉重的疾病,不仅对医疗服务有影响,对许多其他公共和私人护理机构以及患者、家庭和更广泛的社会都有影响。
本文回顾了英国现有的关于精神分裂症(广义定义)成本以及治疗选择和替代护理安排的成本效益的证据。新证据可能会改变我们对这种疾病成本的看法。
汇总英格兰精神分裂症可识别的直接和间接成本表明,每年成本为26亿英镑,但即使这笔费用也忽略了一些目前无法计算成本的间接影响。已确定的总成本中略多于一半由国民保健制度、地方当局、慈善机构和刑事司法系统承担的直接成本构成。在帮助应对这一成本负担方面,现在有大量关于具有成本效益的社区护理安排、抗精神病药物和心理干预措施的证据。
尽管精神分裂症的成本相当高,但有一些治疗方法和护理安排可以在保持或提高疗效的同时减轻这一总体负担。