...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Journal of substance abuse treatment >Re-engineering methadone—Cost-effectiveness analysis of a patient-centered approach to methadone treatment
【24h】

Re-engineering methadone—Cost-effectiveness analysis of a patient-centered approach to methadone treatment

机译：重新设计美沙酮成本效果分析，以患者为中心的美沙酮治疗方法

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Methadone maintenance treatment has proven effectiveness in the treatment of opioid use disorder, but significant barriers remain to treatment retention. In a randomized clinical trial, 300 newly-admitted methadone patients were randomly assigned to patient-centered methadone (PCM)v.treatment-as-usual (TAU). In PCM, participants were treated under revised program rules which permitted voluntary attendance at counseling and other changes focused on reducing involuntary discharge, and different staff roles which shifted disciplinary responsibility from the participant's counselor to the supervisor. The study found no significant differences in treatment retention, measures of opioid use, or other patient outcomes. This paper employs an activity-based costing approach to estimate the cost and cost-effectiveness of the two study conditions. We found that service use and costs were similar between PCM and TAU. Specifically, the average cost for PCM patients was $2396 compared to $2292 for standard methadone, while the average length of stay was 2?weeks longer for PCM patients. Incremental cost-effectiveness ratios (ICER) for self-reported heroin use, opioid positive urine screens, and meeting DSM-IV criteria for opioid dependence were mixed, with TAU achieving non-significantly better outcomes at lower treatment episode costs (i.e., economically dominating) for opioid positive urine screens. PCM patients reported slightly more days abstinent from heroin and fewer meet the opioid dependence criteria. While these differences are small and not statistically significant, we can still examine the cost-effectiveness implications. For days, abstinent from heroin, the ICER was $242 for one additional day of abstinence, however, there was notable uncertainty around this estimate. For opioid dependence criteria, the ICER was $1160 for a one-percentage point increase in the probability that a participant no longer met criteria for opioid dependence at follow-up. This economic study finds that patient choice concepts can be introduced into methadone treatment without significant impacts on costs or patient outcomes.
机译：美沙酮维持治疗在治疗阿片类药物使用障碍方面已经证明了有效性，但仍有额外的障碍留到治疗保留。在随机临床试验中，将300名新建的美沙酮患者随机分配给患者以患者为中心的美沙酮（PCM）V.Treatment-常用（Tau）。在PCM中，参与者根据经修订的计划规则进行处理，该规则允许自愿出勤，以咨询和其他重点的变化，专注于减少非自愿排放，以及将参与者顾问向主管转移纪律责任的不同员工角色。该研究发现，治疗保留，阿片类药物措施或其他患者结果无显着差异。本文采用基于活动的成本核算方法来估计两项研究条件的成本和成本效益。我们发现PCM和TAU之间的服务使用和成本相似。具体而言，PCM患者的平均成本为2396美元，而标准美沙酮为2292美元，而PCM患者的平均逗留时间为2？时间更长。混合了用于自我报告的海洛因使用，阿片类药物阳性尿液屏幕和满足阿片类药物依赖性标准的增量成本效益率（ICER），并在较低的处理发作成本下实现了非显着更好的结果（即经济主导地位） ）对于阿片类药物阳性尿筛。 PCM患者从海洛因繁忙的速度稍微报告稍微报道，较少符合阿片类药物依赖标准。虽然这些差异很小而且没有统计学意义，但我们仍然可以检查成本效益的影响。几天，禁欲来自海洛因，这是一个额外的禁欲一天的戒指，但是，围绕这一估计有了明显的不确定性。对于阿片类药物依赖标准，转轨为1160美元，以便参与者不再符合随访的阿片类药物依赖标准的概率增加。这种经济研究发现，可以将患者选择概念引入美沙酮治疗，而不会对成本或患者结果产生重大影响。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号