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首页> 外文期刊>The British journal of psychiatry : >Costs and consequences of enhanced primary care for depression
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Costs and consequences of enhanced primary care for depression

机译：改善抑郁症初级保健的成本和后果

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Background A number of enhancement strategies have been proposed to improve the quality and outcome of care for depression in primary care settings. Decision-makers are likely to need to know whether these interventions are cost-effective in routine primary care settings. Method We conducted a systematic review of all full economic evaluations (cost-effectiveness and costa€“utility analyses) accompanying randomised controlled trials of enhanced primary care for depression. Costs were standardised to UKpounds/US dollars and incremental cost-effectiveness ratios (ICERs) were visually summarised using a permutation matrix. Results We identified 11 full economic evaluations (4757 patients). A near-uniform finding was that the interventions based upon collaborative care/case management resulted in improved outcomes but were also associated with greater costs. When considering primary care depression treatment costs alone, ICER estimates ranged from ?￡7 ($13, no confidence interval given) to ?￡13 ($24,95% CI a€“105 to 148) per additional depression-free day. Educational interventions alone were associated with increased cost and no clinical benefit. Conclusions Improved outcomes through depression management programmes using a collaborative care/case management approach can be expected, but are associated with increased cost and will require investment.
机译：背景技术已经提出了许多增强策略来改善初级保健机构中抑郁症的护理质量和结果。决策者可能需要了解这些干预措施在常规初级保健机构中是否具有成本效益。方法我们对所有全面的经济评估（成本效益和成本效用分析）进行了系统的回顾，并进行了针对抑郁症加强初级保健的随机对照试验。成本标准化为UKpounds / USD，并且使用排列矩阵直观地总结了增量成本效益比（ICER）。结果我们确定了11项全面的经济评估（4757例患者）。几乎一致的发现是，基于协作式护理/病例管理的干预措施可改善结果，但也带来更高的成本。仅考虑初级保健抑郁症的治疗费用时，ICER估计每增加一天的无抑郁症一天，费用介于7英镑（13美元，没有给出置信区间）到13英镑（24.95％CI，105到148美元）之间。单靠教育干预会增加成本，并且没有临床收益。结论可以预期，通过使用协作治疗/病例管理方法的抑郁症治疗计划可以改善治疗效果，但是这会增加成本，并且需要投资。

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