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首页> 外文期刊>The Australian and New Zealand journal of psychiatry >Economic evaluation of stepped care for the management of childhood anxiety disorders: Results from a randomised trial
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Economic evaluation of stepped care for the management of childhood anxiety disorders: Results from a randomised trial

机译：对儿童焦虑症管理管理的经济评估：随机试验结果

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Background: Stepped care has been promoted for the management of mental disorders; however, there is no empirical evidence to support the cost-effectiveness of this approach for the treatment of anxiety disorders in youth. Method: This economic evaluation was conducted within a randomised controlled trial comparing stepped care to a validated, manualised treatment in 281 young people, aged 7-17, with a diagnosed anxiety disorder. Intervention costs were determined from therapist records. Administrative data on medication and medical service use were used to determine additional health care costs during the study period. Parents also completed a resource use questionnaire to collect medications, services not captured in administrative data and parental lost productivity. Outcomes included participant-completed quality of life, Child Health Utility - nine-dimension and parent-completed Assessment of Quality of Life - eight-dimension to calculate quality-adjusted life years. Mean costs and quality-adjusted life years were compared between groups at 12-month follow-up. Results: Intervention delivery costs were significantly less for stepped care from the societal perspective (mean difference -$198, 95% confidence interval -$353 to -$19). Total combined costs were less for stepped care from both societal (-$1334, 95% confidence interval -$2386 to $510) and health sector (-$563, 95% confidence interval -$1353 to $643) perspectives but did not differ significantly from the manualised treatment. Youth and parental quality-adjusted life years were not significantly different between groups. Sensitivity analysis indicated that the results were robust. Conclusion: For youth with anxiety, this three-step model provided comparable outcomes and total health sector costs to a validated face-to-face programme. However, it was less costly to deliver from a societal perspective, making it an attractive option for some parents. Future economic evaluations comparing various models of stepped care to treatment as usual are recommended.
机译：背景：晋级护理已促进了精神障碍的管理;然而，没有经验证据支持这种方法治疗青年焦虑症的成本效益。方法：这种经济评估在随机对照试验中进行了比较，在281岁的年轻人，7-17岁的年轻人，患有诊断的焦虑症，对经验化的，手术治疗进行了验证的。干预费用取决于治疗师记录。用于药物和医疗服务的行政数据用于在研究期间确定额外的医疗费用。父母还完成了资源使用调查问卷来收集药物，未捕获的行政数据和父母的生产力。结果包括参与者完成的生活质量，儿童卫生效用 - 九维和亲本完成的寿命质量评估 - 八维来计算质量调整的终身。在12个月的随访中，群体之间比较了平均成本和质量调整的终身年。结果：来自社会视角的水平保险的干预送货成本（平均差异 - 198美元，95％的置信区间 - 353美元 - $ 19）。来自社会的加管护理总额较少（ - $ 1334，95％的置信区间 - 2386美元至510美元）和卫生部门（ - $ 563，95％的置信区间 - $ 1353至643美元）的观点，但从手术治疗没有显着差异。青年和父母的父母质量调整后的终身年度没有显着差异。敏感性分析表明，结果是稳健的。结论：对于青少年的焦虑，这三步模型为经过验证的面对面方案提供了可比的结果和总卫生部门成本。然而，从社会角度来看，它的成本较低，使其成为一些父母的有吸引力的选择。建议使用与往常相比，将未来的经济评估与往常相比进行各种模型对治疗进行治疗。

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