Primary-care-based social prescribing for mental health: an analysis of financial and environmental sustainability
Primary-care-based social prescribing for mental health: an analysis of financial and environmental sustainability
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DOI：
10.1017/s1463423615000328
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发表时间：
2016-03-01
影响因子：
1.6
通讯作者：
Cooke, Matthew
中科院分区：
文献类型：
--
作者：
Maughan, Daniel L.;Patel, Alisha;Cooke, Matthew
目的：评估社会处方服务发展对医疗保健使用的影响及其随后的经济和环境成本。背景：精神卫生保健社会处方服务与社区对使用初级保健的人的支持建立联系。社会处方服务可以通过提供结构化的社会心理支持，减少未来的医疗保健使用，从而降低医疗保健的财务和环境成本。根据《气候变化法案》（2008年），英国国家医疗服务体系（NHS）必须在2050年前将其碳足迹减少80%。这项研究首次分析了社会处方后医疗保健使用对财务和环境的影响。这项观察性研究的价值在于其分析初级保健服务碳足迹的新方法。方法：采用一项观察性研究来评估该服务对医疗保健使用的财务和环境影响的影响。测量了全科医生预约、精神药物治疗和二级保健转诊。研究结果：结果显示，两组之间医疗保健使用的财务和碳成本没有统计学差异。社会处方显示出减少医疗保健使用的趋势，主要是由于与对照组相比，二级保健转诊减少。由于样本量小，导致差异存在很大程度的不确定性，因此发现的关联没有达到显著性。这项研究表明，与认知行为疗法或抗抑郁药相比，这些服务有可能通过降低未来的医疗成本来为自己买单，而且是有效的、低碳的干预措施。这是一个重要的发现，因为政府的目标是到2050年将NHS的碳足迹减少80%。需要更大规模的研究来进一步调查社会处方服务的潜力。
Aim: To assess the effects of a social prescribing service development on healthcare use and the subsequent economic and environmental costs. Background: Social prescribing services for mental healthcare create links with support in the community for people using primary care. Social prescribing services may reduce future healthcare use, and therefore reduce the financial and environmental costs of healthcare, by providing structured psychosocial support. The National Health Service (NHS) is required to reduce its carbon footprint by 80% by 2050 according to the Climate Change Act (2008). This study is the first of its kind to analyse both the financial and environmental impacts associated with healthcare use following social prescribing. The value of this observational study lies in its novel methodology of analysing the carbon footprint of a service at the primary-care level. Method: An observational study was carried out to assess the impact of the service on the financial and environmental impacts of healthcare use. GP appointments, psychotropic medications and secondary-care referrals were measured. Findings: Results demonstrate no statistical difference in the financial and carbon costs of healthcare use between groups. Social prescribing showed a trend towards reduced healthcare use, mainly due to a reduction in secondary-care referrals compared with controls. The associations found did not achieve significance due to the small sample size leading to a large degree of uncertainty regarding differences. This study demonstrates that these services are potentially able to pay for themselves through reducing future healthcare costs and are effective, low-carbon interventions, when compared with cognitive behavioral therapy or antidepressants. This is an important finding in light of Government targets for the NHS to reduce its carbon footprint by 80% by 2050. Larger studies are required to investigate the potentials of social prescribing services further.