对识别产前抑郁症的普遍和有针对性的病例调查策略的经济评估:基于模型的分析,比较常见的病例调查工具
Elizabeth M Camacho1,2, Gemma E Shields3, Emily Eisner3,4
1School of Health Sciences, University of Manchester, Manchester, UK. elizabeth.camacho@manchester.ac.uk.
Archives of women's mental health
|October 18, 2023
概括
对于产前抑郁症的普遍查可以节省成本,并且比有针对性的查更有效. 这种方法在孕妇中发现了更多的抑郁症病例,改善了整体健康结果.
科学领域:
- 孕产妇健康 孕产妇健康
- 心理健康经济学 心理健康经济学
- 医疗保健管理的管理
背景情况:
- 围产期抑郁症影响许多女性,目前的日常护理缺少一半的病例.
- 产前抑郁症的错误诊断与产妇服务中的更广泛的不平等有关.
- 需要有效的案例寻找策略来改善识别和资源分配.
研究的目的:
- 为了比较三个产前抑郁症病例发现策略的成本效益:没有查,普遍查和有针对性的查.
- 确定最经济可行的方法来识别孕妇抑郁症.
- 为了为孕产妇心理健康服务的资源分配提供信息.
主要方法:
- 开发了一个决策树模型来模拟怀孕20周左右的病例发现和随后的治疗.
- 费用包括病例发现和治疗;健康益处以质量调整后生命年 (QALYs) 来衡量.
- 模型参数来源于对孕妇的队列研究和现有文献.
主要成果:
- 普遍的案例调查,使用Whooley问题,其次是PHQ-9是最具成本效益的策略.
- 与没有查 (£61) 和有针对性的查 (£62) 相比,普遍查节省了成本 (每名女性52英).
- 与没有查相比,普遍查和有针对性的查都改善了健康结果,普遍查提供了更好的成本效益.
结论:
- 与没有查相比,对产前抑郁症的普遍病例发现是一种节省成本的策略.
- 普遍查比有针对性的查更具成本效益,尽管成本相似,因为健康收益更大.
- 实施通用查可以提高怀孕妇女患抑郁症的鉴定率和健康结果.
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