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危机解决服务的经济评估:一项随机对照试验。

Economic evaluation of a crisis resolution service: a randomised controlled trial.

作者信息

McCrone Paul, Johnson Sonia, Nolan Fiona, Pilling Stephen, Sandor Andrew, Hoult John, McKenzie Nigel, Thompson Marie, Bebbington Paul

机构信息

Health Service and Population Research Department, Institute of Psychiatry, King's College London, UK.

出版信息

Epidemiol Psichiatr Soc. 2009 Jan-Mar;18(1):54-8. doi: 10.1017/s1121189x00001469.

Abstract

AIMS

The use of specialised services to avoid admission to hospital for people experiencing mental health crises is seen as an integral part of psychiatric services in some countries. The aim of this paper is to assess the impact on costs and cost-effectiveness of a crisis resolution team (CRT).

METHODS

Patients who were experiencing mental health crises sufficient for admission to be considered were randomised to either care provided by a CRT or standard services. The primary outcome measure was inpatient days over a six-month follow-up period. Service use was measured, costs calculated and cost-effectiveness assessed.

RESULTS

Patients receiving care from the CRT had non-inpatient costs pounds sterling 768 higher than patients receiving standard care (90% CI, pounds sterling 153 to pounds sterling 1375). With the inclusion of inpatient costs the costs for the CRT group were pounds sterling 2438 lower for the CRT group (90% CI, pounds sterling 937 to pounds sterling 3922). If one less day spent as an inpatient was valued at pounds sterling 100, there would be a 99.5% likelihood of the CRT being cost-effective.

CONCLUSION

This CRT was shown to be cost-effective for modest values placed on reductions in inpatient stays.

摘要

目的

在一些国家,利用专门服务避免心理健康危机患者住院被视为精神科服务的一个组成部分。本文旨在评估危机解决团队(CRT)对成本和成本效益的影响。

方法

将有足够理由住院的心理健康危机患者随机分为接受CRT护理或标准服务。主要结局指标是六个月随访期内的住院天数。测量服务使用情况,计算成本并评估成本效益。

结果

接受CRT护理的患者非住院成本比接受标准护理的患者高768英镑(90%置信区间,153英镑至1375英镑)。纳入住院成本后,CRT组的成本比标准护理组低2438英镑(90%置信区间,937英镑至3922英镑)。如果将少住院一天的价值设定为100英镑,CRT具有成本效益的可能性为99.5%。

结论

对于因住院天数减少而设定的适度价值,该CRT显示出具有成本效益。

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