积极性社区干预治疗精神分裂症患者的成本-效果分析

发布时间：2018-05-20 20:11

本文选题：社区精神卫生服务 + 精神分裂症　；参考：《中国全科医学》2014年32期

【摘要】：目的探讨积极性社区干预治疗精神分裂症患者的成本-效果。方法选取2012年12月—2013年2月无锡市南长区重性精神病规范化管理的慢性精神分裂症患者120例,使用随机数字表法将其均分为研究组和对照组,研究组给予积极性社区干预,对照组提供常规社区精神卫生服务,随访观察1年。采用自制社区精神疾病成本调查表、阳性与阴性症状量表(PANSS)、世界卫生组织生命质量测定量表简表(WHOQOL-BREF)对两组患者的治疗成本-效果进行评估。结果两组患者的性别构成、年龄、首次发病年龄、婚姻状态、受教育年限、病程、住院次数、药物剂量、家庭月收入、服药依从性、主要照顾者情况比较,差异均无统计学意义(P0.05)。两组总成本比较,差异无统计学意义(P0.05)。研究组社区精神病防治费用、住院费用、住院探视交通费用、家属照顾缺勤费用低于对照组,差异有统计学意义(P0.05)。干预前两组患者PANSS得分、WHOQOL-BREF得分比较,差异均无统计学意义(P0.05)。干预后1年时两组PANSS评分减分量(E1)、WHOQOL-BREF评分增分量(E2)比较,差异均有统计学意义(P0.05)。分别以PANSS得分、WHOQOL-BREF得分为治疗效果进行成本-效果分析,PANSS评分每减少1分、WHOQOL-BREF评分每增加1分,研究组的平均成本-效果比(C/E1和C/E2)均低于对照组。敏感性分析显示,假设总成本下降10%而E1、E2维持不变时,研究组的成本-效果仍低于对照组。结论积极性社区干预能有效改善慢性精神分裂症患者的临床症状和生活质量,较传统社区卫生服务更具有卫生经济学价值,是一种经济有效的社区康复模式,值得推广应用。
[Abstract]:Objective to explore the cost-effect of active community intervention in the treatment of schizophrenia. Methods from December 2012 to February 2013, 120 patients with chronic schizophrenia with standardized management of severe psychosis in Nanchang District, Wuxi City, were selected and divided into study group and control group by random number table method. The study group was given positive community intervention. The control group provided routine community mental health services, followed up for 1 year. The cost of mental illness in the community, the positive and negative symptoms scale (PANSS), and the World Health Organization quality of Life scale (WHOQOL-BREFF) were used to evaluate the cost-effectiveness of the two groups. Results the sex composition, age, age of first onset, marital status, years of education, course of disease, times of hospitalization, dosage of drugs, monthly income of family, compliance with medication, and the main caregivers were compared between the two groups. The difference was not statistically significant (P 0.05). There was no significant difference in total cost between the two groups (P 0.05). In the study group, the expenses of community psychiatric prevention and treatment, hospitalization and transportation, and the cost of family care and absence were lower than those of the control group, and the difference was statistically significant (P 0.05). There was no significant difference in PANSS score and WHOQOL-BREF score between the two groups before intervention (P 0.05). At 1 year after intervention, there were significant differences between the two groups in PANSS score, E1QOL-BREF score and E2 (P 0.05). Cost-effectiveness analysis using PANSS score and WHOQOL-BREF score as therapeutic effect, the average cost-effect ratio of the study group was lower than that of the control group for each decrease of 1 point in the PANSS score and the increase of the WHOQOL-BREF score. Sensitivity analysis showed that the cost-effect of the study group was still lower than that of the control group assuming that the total cost decreased by 10% and the E _ 1 / E _ 2 remained unchanged. Conclusion the positive community intervention can effectively improve the clinical symptoms and quality of life of the patients with chronic schizophrenia, and has more health economics value than the traditional community health service. It is an economical and effective community rehabilitation model, which is worth popularizing and applying.
【作者单位】：南京医科大学附属无锡精神卫生中心;无锡市南长区社区卫生服务中心;
【分类号】：R749.3

【参考文献】