在初级保健中,对患有抑郁症和身体并发症的人进行心理教育小组干预的成本效益和成本效益研究
Antonia Raya-Tena1, María Isabel Fernández-San-Martín2, Jaume Martín-Royo3
1Centre d'Atenció Primària Dr. Lluís Sayé, ABS Raval Nord, Institut Català de la Salut, Barcelona, Spain; Línea d'Investigació en Biomedicina, Epidemiologia i Pràctica Clínica Avançada, Facultat de Infermeria, Universitat Rovira i Virgili, Tarragona, Spain.
Enfermeria clinica (English Edition)
|March 20, 2024
概括
这项研究发现,对患有抑郁症和身体状况的患者进行的心理教育小组干预改善了无抑郁症日 (DFD) 并在12个月内降低了成本,尽管不是显著的. 经质量调整的寿命年 (QALYs) 在各组之间仍然相似.
科学领域:
- 卫生经济学 卫生经济学
- 初级保健护理护理 基本护理护理
- 心理健康干预 心理健康干预
背景情况:
- 患有身体相关疾病的患者经常患有抑郁症,影响他们的生活质量.
- 初级保健机构对于管理慢性疾病和心理健康至关重要.
- 需要具有成本效益的干预措施来解决患有同时存在身体疾病的患者的抑郁症.
研究的目的:
- 评估由护士领导的精神教育小组干预的成本效益和成本效益.
- 评估干预措施对预防抑郁症和改善身体伴随疾病患者生活质量的影响.
- 在初级保健背景下,将干预与传统护理进行比较.
主要方法:
- 经济评估利用随机多中心临床试验 (PSICODEP研究) 的数据进行了一年的随访.
- 包括被诊断患有抑郁症和身体相关疾病 (糖尿病,缺血性心脏病,COPD,喘) 的50岁以上的患者.
- 干预包括12个每周的心理教育小组会议,由训练有素的初级护理护士领导;有效性以无抑郁日 (DFD) 和质量调整生命年 (QALYs) 衡量.
主要成果:
- 干预组 (n=204) 与对照组 (n=176) 相比,平均增加了11.95个无抑郁日 (DFD).
- 干预组的住院和临时残疾费用较低,但初级保健访问费用较高,导致12个月的成本差异为-357.95欧元.
- 经质量调整的寿命年 (QALYs) 在各组之间相似 (差异 -0.01).
结论:
- 心理教育干预表明了改善无抑郁日和降低整体成本的趋势.
- 虽然在统计学上并不显著,但研究结果表明,在这种患者群体中,对治疗抑郁症有潜在的益处.
- 干预的成本效益分析表明,每个DFD的增量成本效益比率 (ICER) 为29.95欧元,每QALY为35,795欧元.
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