对发展障碍儿童的护理人员干预措施的经济评估:一个范围审查
Angela Kairu1, Edwin Dzoro2, Vibian Angwenyi2
1Health Economics Research Unit (HERU), KEMRI Wellcome Trust Research Programme, Nairobi, Kenya.
PLOS global public health
|June 30, 2025
概括
对于发展障碍 (DDs) 的儿童,护理人员的干预是具有成本效益的,为改善服务获取提供了一个有希望的方法. 需要进一步的经济评估,特别是在低收入国家,以指导资源分配和促进公平的护理.
科学领域:
- 卫生经济学 卫生经济学
- 发育儿科 发育儿科
- 公共卫生政策 公共卫生政策
背景情况:
- 有发展障碍儿童的家庭面临着重大挑战,包括社会隔离,耻辱和贫困,特别是在低收入的非洲环境中.
- 在非洲,大多数患有DD的儿童仍然未被识别,无法获得正式的支持服务.
- 照顾者干预,专注于父母教育和培训,是适应性和低强度的,但经济证据有限.
研究的目的:
- 系统地审查和描述经济评估的证据和方法方面,对DDS儿童的照顾者干预进行评估.
- 确定使用的经济评估方法的类型及其有关成本效益和成本节约潜力的发现.
- 在对这些干预措施的经济评估中强调方法论上的挑战和未来研究领域.
主要方法:
- 针对1993年至2023年间发表的研究,对7个电子数据库,灰色文献和引用参考进行了系统的搜索.
- 阿克西和奥马利的框架指导了审查过程.
- 使用德拉蒙德检查清单来评估研究质量,并使用感应主题分析提取和合成数据.
主要成果:
- 包括20项来自高收入国家的研究,重点关注自闭症谱系障碍,多动症多动症,破坏性行为,智力障碍和语言延迟的干预措施.
- 经济评估包括成本效益 (11项研究),成本 (3),成本效益 (2),成本后果 (1) 和成本效益 (1).
- 九项研究报告说,干预措施具有成本效益,五项研究发现干预措施节省了成本. 关键的方法挑战包括成本计算,结果测量和适当的时间范围.
结论:
- 对患有DD的儿童进行的护理人员干预表明了显著的成本效益和节省成本的潜力.
- 这些干预措施是加强服务获取和降低相关医疗保健成本的有希望的策略.
- 进一步的经济评估研究,特别是在非洲等代表性不足的地区,对于明智的决策,高效的资源分配和促进DDS儿童包容性,公平获得服务至关重要.
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