Estimating the cost and value of functional changes in communication ability following telepractice treatment for aphasia.
Estimating the cost and value of functional changes in communication ability following telepractice treatment for aphasia.
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DOI：
10.1371/journal.pone.0257462
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Ellis C
中科院分区：
文献类型：
--
作者：
Jacobs M;Ellis C
失语症是一种中风后的情况，可以极大地影响具有失语症(PWA)沟通能力的人。到目前为止，很少有研究考虑失语症功能改变的成本和成本效益，也没有考虑患者对失语症治疗价值的衡量标准。评估接受失语症远程康复治疗的个体改善功能性沟通的成本、成本效益和感知价值。20名PWA在6周的时间内完成了5至12次远程保健康复，时间为45-60分钟，采用了旨在解决失语症患者一系列语言问题的面向语言的治疗(LOT)。在康复前和康复结束时完成国家结果测量(NOMS)、理解和口头表达以及阿莎沟通生活质量(QCL)，以获得基线和治疗措施。年龄、教育程度和种族与名词表达能力的提高显著相关。非洲裔美国人(OR=2.0917)在治疗后改善的可能性是白人的两倍。改善的可能性也随着受教育年限的增加而增加(OR=1.002)，但随着年龄的增加而降低(OR=0.9463)。共有15名PWA患者的NOMS理解能力有改善，9名患者的NOMS语言表达能力有改善。病情好转的患者接受了5至12次治疗。改善NOMS理解能力的平均成本为每名患者1,152美元，改善NOMS口头表达的平均成本为每名患者1,128美元，个别治疗成本在540美元至1,296美元之间。然而，平均而言，患者改善后的QCL的货币等值在1,790.39美元至3,912，54美元之间-远远超过治疗的经济成本。在测量失语症患者的功能改善时，患者从治疗中获得的沟通生活质量超过了所提供服务的财务成本。
Aphasia is a post-stroke condition that can dramatically impact a person with aphasia’s (PWA) communication abilities. To date, few if any studies have considered the cost and cost-effectiveness of functional change in aphasia nor considered measures of patient’s value for aphasia treatment. To assess the cost, cost-effectiveness, and perceived value associated with improved functional communication in individuals receiving telerehabilitation treatment for aphasia. Twenty PWA completed between 5 and 12 telehealth rehabilitation sessions of 45–60 minutes within a 6-week time frame using a Language-Oriented Treatment (LOT) designed to address a range of language issues among individuals with aphasia. National Outcomes Measures (NOMS) comprehension and verbal expression and the ASHA Quality of Communication Life (QCL) were completed prior to and at the completion of rehabilitation to obtain baseline and treatment measures. Age, education, and race are significantly correlated with improvement in the NOMS verbal expression. African Americans (OR = 2.0917) are twice as likely as Whites to experience improvement after treatment. The likelihood of improvement also increases with each additional year of education (OR = 1.002) but decrease with age (OR = 0.9463). A total of 15 PWA showed improvement in NOMS comprehension and nine patients showed improvement in NOMS verbal expression. Improving patients attended between five and 12 treatment sessions. The average cost of improvement in NOMS comprehension was $1,152 per patient and NOMS verbal expression was $1,128 per patient with individual treatment costs varying between $540 and $1,296. However, on average, the monetary equivalent in patient’s improved QCL was between $1,790.39 to $3,912,54—far exceeding the financial cost of treatment. When measuring the functional improvement of patients with aphasia, patient’s quality of communication life received from treatment exceeded financial cost of services provided.
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