治疗精神病超高风险患者的风险分层:一个成本效益分析
Olajumoke M Ologundudu1, Lena Palaniyappan2, Lauren E Cipriano3
1Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada.
Schizophrenia research
|October 7, 2023
概括
治疗所有患有精神病超高风险 (UHR) 的人可能具有成本效益,尽管风险分层显示较低的初始成本和质量调整后寿命年 (QALYs). 需要进一步分析,因为结果对转换概率敏感.
科学领域:
- 精神病学是一个精神病学.
- 卫生经济学 卫生经济学
- 公共卫生 公共卫生
背景情况:
- 患有精神病的超高风险 (UHR) 个体通常会获得预防性护理,无论他们的具体转化风险如何.
- 管理UHR个人的最佳策略,以预防第一发精神病 (FEP) 需要经济评估.
研究的目的:
- 评估治疗所有UHR患者的成本效益与预防精神病的风险分层.
- 从加拿大医疗保健系统的角度来看,在15年的时间里比较成本和质量调整后的寿命年 (QALYs).
主要方法:
- 开发了一个使用决策树和马尔科夫模型的经济模型.
- 包括健康状况:没有UHR,UHR风险<20%,UHR风险≥20%,FEP,缓解,FEP后和死亡.
- 输入数据包括转换概率,生活质量和成本.
主要成果:
- 风险分层 (仅对那些风险≥20%的人进行治疗) 导致每人成本较低 (1398美元) 和QALY (0.055) .
- 治疗所有UHR患者的增量性成本效益比 (ICER) 为25,448美元/QALY.
- 模型结果对转化为精神病的概率敏感.
结论:
- 治疗所有患有精神病超高风险的人可能是一个具有成本效益的策略.
- 风险分层似乎成本更低,但产生的QALY较少.
- 处理所有UHR个人的决定值得考虑,特别是考虑到模型对转换概率的敏感性.
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