When the cradle falls II: the cost-effectiveness of treating postnatal depression in a psychiatric day hospital compared with routine primary care
When the cradle falls II: the cost-effectiveness of treating postnatal depression in a psychiatric day hospital compared with routine primary care
复制标题
DOI：
10.1016/s0165-0327(02)00007-1
复制
发表时间：
2003-04-01
影响因子：
6.6
通讯作者：
Cox, J
中科院分区：
文献类型：
--
作者：
Boath, E;Major, K;Cox, J
背景资料：这项前瞻性队列研究评估了在专门的精神病父母和婴儿日单位（PBDU）治疗30名产后抑郁症（PND）妇女的成本效益，与30名使用常规初级保健（RPC）治疗的妇女相比。研究方法：招募后，妇女进行了评估，在三个场合（最初，3个月和6个月），使用各种社会和精神结果的措施。直接和间接成本进行了整理，使用结构化访谈，回顾性分析的情况下，笔记和定期整理NHS的成本数据。还进行了敏感性分析。结果如下：两组妇女的社会人口特征或结果测量分数最初没有显著差异。然而，在6个月时，PBDU组中的21名女性不再抑郁，而RPC组中只有7名女性。PBDU组的总费用为46 211英镑，RPC组为18 973英镑。从RPC向PBDU转变将涉及27 238英镑（46 211-18 973英镑）的额外支出，同时产生14个更积极的成果。从RPC转到PBDU将使每名成功治疗的妇女增加1 945英镑（27 238/14）的费用。这与RPC组中每名成功治疗的妇女目前的费用2 710英镑（18 973/7）相比是有利的。结论：基于PBDU治疗的成本效益，RPC占主导地位，因此应向卫生保健决策者推荐PBDU治疗。研究的局限性：结果对纳入初级保健接触和药物费用敏感。(C)2002 Elsevier Science B. V.保留所有权利。
Background: This prospective cohort study assessed the cost-effectiveness of treating 30 women with postnatal depression (PND) at a specialised psychiatric Parent and Baby Day Unit (PBDU), compared to 30 women treated using routine primary care (RPC). Methods: Following recruitment, the women were assessed on three occasions (initially, 3- and 6-months), using a variety of social and psychiatric outcome measures. Direct and indirect costs were collated using structured interviews, retrospective analysis of case notes and routinely collated NHS cost data. Sensitivity analysis was also carried out. Results: There was no significant difference between the women in the two groups initially in terms of their socio-demographic characteristics, or scores on the outcome measures. However, at 6-months, 21 women in the PBDU group were no longer depressed compared to only seven women in the RPC group. The total cost was pound46 211 for the PBDU group and pound18 973 for the RPC group. Moving from RPC to a PBDU would involve an additional expenditure of pound27 238 (46 211-18 973) whilst delivering 14 more positive outcomes. The move from RPC to PBDU would incur an additional cost per successfully treated woman of pound1945 (27 238/14). This compares favourably with the current cost per successfully treated woman in the RPC group of pound2710 (18 973/7). Conclusions: RPC is dominated on the grounds of cost-effectiveness by PBDU treatment and so PBDU treatment should be recommended to health care decision-makers. Limitations of the study: The results were sensitive to the inclusion of primary care contacts and the costs of medication. (C) 2002 Elsevier Science B.V. All rights reserved.