Collaborative mental health care for pediatric behavior disorders in primary care: Does it reduce mental health care costs?
Collaborative mental health care for pediatric behavior disorders in primary care: Does it reduce mental health care costs?
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DOI：
10.1037/fsh0000251
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发表时间：
2017-03
期刊：
影响因子：
--
通讯作者：
Torres E
中科院分区：
文献类型：
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作者：
Yu H;Kolko DJ;Torres E
最近完成的一项随机对照试验(RCT)证明了相对于增强型日常护理(EUC)，医生-办公室协作护理(DOCC)对儿童行为问题和注意力缺陷/多动障碍的有效性。这项研究试图通过在上述试验结束时加入成本分析部分来扩展文献。据我们所知，这是第一次研究DOCC模式是否会降低儿童心理健康服务的成本。RCT的财务记录提供了6个月干预期内所有321名研究儿童的成本信息，保险计划的索赔数据提供了干预前和干预后57名儿童的社区心理健康服务的成本信息，这些儿童的父母同意公布他们的索赔数据。进行了描述性和多变量分析。DOCC组的干预成本较高，但在6个月的干预期内，DOCC组的每位患者的治疗成本低于EUC组。社区精神卫生服务费用方面，两组在干预前6个月的费用基本相同，而DOCC组在干预后6个月、干预后6个月和12个月的社区精神卫生服务费用明显低于干预前6个月和12个月，而在干预后18个月和24个月的社区精神卫生服务费用无显著差异。DOCC模型在提高临床有效性的同时，有可能在干预期和干预后立即的随访期节省成本。
One recently completed randomized controlled trial (RCT) demonstrated the effectiveness of a Doctor-Office Collaborative Care (DOCC), relative to Enhanced Usual Care (EUC), for pediatric behavior problems and attention-deficit/hyperactivity disorder. This study seeks to extend the literature by incorporating a cost analysis component at the conclusion of the aforementioned trial. To our knowledge, it is the first study that examines whether the DOCC model leads to lower costs of mental health services for children. Financial records from the RCT provide cost information about all the 321 study children in the 6-month intervention period, and claims data from insurance plans provide cost information about community mental health services for 57 children, whose parents consented to release their claims data, in both pre and post-intervention periods. Both descriptive and multivariate analyses were performed. The DOCC group had higher intervention costs, but the cost per patient treated for the DOCC group was lower than the EUC group during the 6-month intervention period. In terms of costs of community mental health services, while the two groups had similar costs in the 6 months before the RCT intervention, the DOCC group had significantly lower costs in the 6-month intervention period, and in the 6 or 12 months after the intervention, but not in the 18 or 24 months after the intervention. The DOCC model has the potential for cost savings during the intervention period and the follow-up periods immediately after the intervention while improving clinical effectiveness.