The effectiveness and cost-effectiveness of integrating mental health services in primary care in low- and middle-income countries: systematic review.
The effectiveness and cost-effectiveness of integrating mental health services in primary care in low- and middle-income countries: systematic review.
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DOI：
10.1192/bjb.2020.35
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发表时间：
2021-03
期刊：
影响因子：
2.6
通讯作者：
Marsch LA
中科院分区：
文献类型：
--
作者：
Cubillos L;Bartels SM;Torrey WC;Naslund J;Uribe-Restrepo JM;Gaviola C;Díaz SC;John DT;Williams MJ;Cepeda M;Gómez-Restrepo C;Marsch LA
本系统性综述探讨了在低收入和中等收入国家将行为健康纳入初级卫生保健管理抑郁症和不健康饮酒的有效性和成本效益。根据PRISMA指南，该综述包括研究年龄≥18岁的不健康饮酒和/或任何临床严重程度的抑郁症患者的研究。整合模式的探索被用来解释特定于低收入和中等收入国家的行为健康整合的类型。58篇文章符合纳入标准。研究表明，综合护理比常规治疗对这两种疾病的有效性更高。经济评价发现，直接保健费用增加，但估计数具有成本效益。纳入的研究使用了六种不同的行为健康整合模型。行为健康的整合可能会产生更好的健康结果，尽管它可能需要额外的资源。拟议的分类法可协助决策者推进综合模型的实施。
This systematic review examines the effectiveness and cost-effectiveness of behavioural health integration into primary healthcare in the management of depression and unhealthy alcohol use in low- and middle-income countries. Following PRISMA guidelines, this review included research that studied patients aged ≥18 years with unhealthy alcohol use and/or depression of any clinical severity. An exploration of the models of integration was used to characterise a typology of behavioural health integration specific for low- and middle-income countries. Fifty-eight articles met inclusion criteria. Studies evidenced increased effectiveness of integrated care over treatment as usual for both conditions. The economic evaluations found increased direct health costs but cost-effective estimates. The included studies used six distinct behavioural health integration models. Behavioural health integration may yield improved health outcomes, although it may require additional resources. The proposed typology can assist decision-makers to advance the implementation of integrated models.
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