评估恢复工作干预措施对健康和经济的影响:一项建模研究
Niccolò Morgante1, Gudrun Maria Waller Bjørnelv1, Lene Aasdahl2
1Department of Health Management and Health Economics, University of Oslo, Oslo, Norway; Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.
在挪威,住院多式模式职业康复 (I-MORE) 除非包括社会生产损失在内,否则病假的成本效益不大. 在评估回归工作干预措施时,更广泛的经济视角至关重要.
科学领域:
- 卫生经济学 卫生经济学
- 职业健康 职业健康 职业健康
- 康复医学 康复医学 康复医学
背景情况:
- 挪威的病假率达到了15年来的最高水平,需要采取有效的干预措施.
- 政策制定者需要可靠的数据来指导对高价值病假干预措施的决策.
研究的目的:
- 评估挪威针对肌肉骨和心理疾病的两项返回工作 (RTW) 干预措施的成本效益.
- 使用决策分析建模,将门诊接受和承诺治疗 (O-ACT) 与住院多式模式职业康复 (I-MORE) 进行比较.
主要方法:
- 一个决策分析模型是使用一个随机试验中166个人的数据开发的.
- 该模型纳入了25年时间的过渡概率,医疗保健成本,生产损失和质量调整寿命年 (QALYs).
- 使用概率敏感性分析来评估成本效益.
主要成果:
- 与O-ACT相比,I-MORE促进了更快的返回工作.
- 从医疗保健的角度来看,I-MORE在50,000美元/QALY的门下是不具有成本效益的 (98%的模拟).
- 包括社会生产损失在内,I-MORE被证明比O-ACT更有利,成本更低.
结论:
- 根据目前的挪威基准,如果不考虑生产损失,I-MORE的成本效益不高.
- 调查结果强调了在对RTW干预措施的经济评估中采用社会视角至关重要.
- 目前挪威的指导方针不建议社会视角,这可能会限制对I-MORE等干预措施的评估.
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