The economic case for digital interventions for eating disorders among United States college students
The economic case for digital interventions for eating disorders among United States college students
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DOI：
10.1002/eat.22680
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发表时间：
2017-03-01
影响因子：
5.5
通讯作者：
Taylor, C. Barr
中科院分区：
文献类型：
--
作者：
Kass, Andrea E.;Balantekin, Katherine N.;Taylor, C. Barr
目的：进食障碍是影响大学生健康的严重问题。本文旨在估计美国大学生在线预防和治疗的阶梯式护理模式的成本（以美元计），以告知有关资源分配和采用大学校园ED有效护理提供模式的有意义的决策。方法：从付款人的角度来看，我们估计了（1）向ED患者提供在线指导自助（GSH）干预的成本，包括“逐步提高”预期“失败”比例的成本;（2）提供在线预防干预与“等待和治疗”方法相比，对艾德风险个体;（3）在1,000名学生中应用阶梯式护理模式，与标准护理相比。结合在线GSH和预防干预的结果，我们估计阶梯式护理模式的成本更低，需要面对面心理治疗的人也更少（在接受不太密集的干预后）与标准护理相比，假设每个需要干预的人都接受了干预。与标准护理相比，阶梯式护理模式估计可实现适度的成本节约，但这些估计需要进行敏感性分析。模型假设强调了成本计算的复杂性，以告知资源分配，并提出了一个可传播的交付模式的考虑因素。需要努力系统地衡量大学校园ED阶梯式护理模式的成本和效益，提高艾德干预的精度和有效性，并将这些计算应用于具有不同成本结构的非美国护理系统。
Objective: Eating disorders (EDs) are serious health problems affecting college students. This article aimed to estimate the costs, in United States (US) dollars, of a stepped care model for online prevention and treatment among US college students to inform meaningful decisions regarding resource allocation and adoption of efficient care delivery models for EDs on college campuses.Methods: Using a payer perspective, we estimated the costs of (1) delivering an online guided self-help (GSH) intervention to individuals with EDs, including the costs of "stepping up" the proportion expected to "fail"; (2) delivering an online preventive intervention compared to a " wait and treat" approach to individuals at ED risk; and (3) applying the stepped care model across a population of 1,000 students, compared to standard care.Results: Combining results for online GSH and preventive interventions, we estimated a stepped care model would cost less and result in fewer individuals needing in-person psychotherapy (after receiving less-intensive intervention) compared to standard care, assuming everyone in need received intervention.Conclusions: A stepped care model was estimated to achieve modest cost savings compared to standard care, but these estimates need to be tested with sensitivity analyses. Model assumptions highlight the complexities of cost calculations to inform resource allocation, and considerations for a disseminable delivery model are presented. Efforts are needed to systematically measure the costs and benefits of a stepped care model for EDs on college campuses, improve the precision and efficacy of ED interventions, and apply these calculations to non-US care systems with different cost structures.