在野火疏散者中对创伤后应激障碍的查和治疗:成本效益分析
Michael Lebenbaum1,2,3, S Ahmed Hassan1
1Institute of Health Policy, Management and Evaluation (IHPME), University of Toronto, Toronto, ON, Canada.
MDM policy & practice
|June 21, 2024
概括
在野火疏散者中,对创伤后应激障碍 (PTSD) 的查,然后用帕洛或创伤集中认知行为疗法 (TF-CBT) 进行治疗,可以节省成本. TF-CBT是最具成本效益的干预措施,提供额外的质量调整寿命年 (QALY).
科学领域:
- 环境健康 环境健康
- 心理健康服务研究 心理健康服务研究
- 卫生经济学 卫生经济学
背景情况:
- 由于气候变化,全球范围内的野火正在增加.
- 野火幸存者面临着创伤后应激障碍 (PTSD) 的高负担.
- 对于森林火灾疏散人员的PTSD治疗的成本效益仍然没有研究.
研究的目的:
- 进行成本效益分析,比较PTSD查和治疗与加拿大大火灾疏散者没有查.
- 评估帕洛克塞丁和以创伤为重点的认知行为疗法 (TF-CBT) 作为治疗选择.
- 从社会和医疗保健的角度确定最具成本效益的战略.
主要方法:
- 一个马尔科夫模型被用来评估成本和质量调整的寿命年 (QALYs) 在5年的时间范围内.
- 从医疗保健和社会角度进行了分析.
- 概率和确定性灵敏度分析评估了不确定性在5万美元的支付意愿门以下.
主要成果:
- 从社会角度来看,对帕洛或TF-CBT进行查之后的查占主导地位,没有查.
- TF-CBT在QALY每年5万美元的成本效益率上显示了最高的概率 (0.649) .
- 从医疗保健的角度来看,在相同的门上,这两种干预措施都没有成本效益.
结论:
- 对PTSD进行查,然后进行TF-CBT或帕洛克,可以节省成本,并改善野火疏散人员的QALY.
- 政府应该考虑为野火疏散者提供PTSD查计划的资金.
- 推TF-CBT作为首选的治疗选择,因为其成本效益的可能性更高.
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