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首页> 外文期刊>The Australian and New Zealand journal of psychiatry >Assessing the cost of early intervention in psychosis: A systematic review.
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Assessing the cost of early intervention in psychosis: A systematic review.

机译：评估精神病早期干预的成本：系统审查。

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Objective: Early-intervention units have proliferated over the last decade, justified in terms of cost as well as treatment effect. Strong claims for extension of these programmes on economic grounds motivate a systematic review of economic evaluations of early-intervention programmes. Method: Searches were undertaken in the Cochrane Central Register of Controlled Trials, PubMed, EMBASE, and PsycINFO with keywords including 'early intervention', 'ultra-high risk', 'prodrome', 'cost-effectiveness', 'psychosis', 'economic', and 'at-risk mental state'. Relevant journals, editorials, and the references of retrieved articles were hand-searched for appropriate research. Results: Eleven articles were included in the review. The more rigorous research (two randomized control trials and two quasi-experimental studies) suggested no difference in resource utilization or costs between early-intervention and treatment-as-usual groups. One small case-control study with evidence of significant bias concluded annual early-intervention costs were one-third of treatment-as-usual costs. Modelling studies projected reduced costs of early intervention but were based on assumptions since definitively revised. Cost-effectiveness analyses did not strongly support the cost-effectiveness of early intervention. No studies appropriately valued outpatient costs or addressed the feasibility of realizing reduced hospitalization in reduced costs. Conclusions: The published literature does not support the contention that early intervention for psychosis reduces costs or achieves cost-effectiveness. Past failed attempts to reduce health costs by reducing hospitalization, and increased outpatient costs in early-intervention programmes suggest such programmes may increase costs. Future economic evaluation of early-intervention programmes would need to correctly value outpatient costs and accommodate uncertainty regarding reduced hospitalization costs, perhaps by sensitivity analysis. The current research hints that cost differences may be greater early in treatment and in patients with more severe illness.
机译：目的：早期介入单位在过去十年中有增殖，在成本和治疗效果方面是合理的。强烈索赔，延长这些关于经济理由的计划激励对早期申请计划的经济评估的系统审查。方法：在Cochrane中央登记册中进行的受控试验中的Cochrane中央登记，PubMed，Embase和Psycinfo，带有关键词，包括“早期干预”，“超高风险”，“前驱性”，“成本效益”，“精神病”，“经济'和“风险精神状态”。相关的期刊，编辑和检索物品的参考文章被手动搜索适当的研究。结果：第十一文章综述综述。更严格的研究（两个随机对照试验和两项准实验研究）表明，早期干预和治疗之间的资源利用或成本没有差异。一个小病例对照研究，具有显着偏见的证据结束，年早期干预费用是常见费用的三分之一。建模研究预计提前干预的成本降低，但基于自明确修订的假设。成本效益分析并未强烈支持早期干预的成本效益。无需研究适当的门诊成本或解决了降低成本降低住院病的可行性。结论：出版的文献不支持早期干预精神病的争论降低成本或实现成本效益。通过减少住院治疗的过去失败的尝试减少了健康成本，提前干预计划的增加的门诊成本建议这些方案可能会增加成本。未来的早期申请计划的经济评估需要正确地重视门诊成本，并通过敏感性分析来适应降低住院费用的不确定性。目前的研究暗示成本差异可能早期治疗和更严重的患者患者。

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