Assessing cost-effectiveness in mental health: family interventions for schizophrenia and related conditions.
OBJECTIVE: Existing evidence suggests that family interventions can be effective in reducing relapse rates in schizophrenia and related conditions. Despite this, such interventions are not routinely delivered in Australian mental health services. The objective of the current study is to investigate...
| Publicado en: | Australian & New Zealand Journal of Psychiatry Vol. 38; no. 7; pp. 511 - 520 |
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| Autores principales: | , , , |
| Formato: | clinical trial equations & formulas research tables/charts Journal Article |
| Publicado: |
Sage Publications Inc.
Jul2004
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106546881&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106546881 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00048674 7ZU jtl: Australian & New Zealand Journal of Psychiatry issn: 00048674 maglogo: Y pubinfo: dt: Jul2004 vid: 38 iid: 7 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 106546881 106546881 2009060852 10.1080/j.1440-1614.2004.01404.x NLM15255823 106546881 ppf: 511 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Assessing cost-effectiveness in mental health: family interventions for schizophrenia and related conditions. aug: au: Mihalopoulos C Magnus A Carter R Vos T affil: Program Evaluation Unit, School of Population Health, University of Melbourne, Victoria 3010, Australia; c.mihalopoulos@unimelb.edu.au sug: subj: Behavior Therapy Economics Mental Health Services Economics Schizophrenia Therapy Family Therapy Economics Psychotherapy, Group Economics Cost Benefit Analysis Adult Aged Australia Behavior Therapy Methods Family Female Goals and Objectives Male Middle Age Patient Education Schizophrenia Economics Intervention Trials Descriptive Statistics Costs and Cost Analysis Methods Mathematics Data Analysis Software Problem Solving Psychotic Disorders Economics Psychotic Disorders Epidemiology Psychotic Disorders Therapy Recurrence Prevention and Control Schizophrenia Epidemiology Sensitivity and Specificity Stress, Psychological Prevention and Control Stress, Psychological Psychosocial Factors Human Adult: 19-44 years Aged: 65+ years Middle Aged: 45-64 years Female Male ab: OBJECTIVE: Existing evidence suggests that family interventions can be effective in reducing relapse rates in schizophrenia and related conditions. Despite this, such interventions are not routinely delivered in Australian mental health services. The objective of the current study is to investigate the incremental cost-effectiveness ratios (ICERs) of introducing three types of family interventions, namely: behavioural family management (BFM); behavioural intervention for families (BIF); and multiple family groups (MFG) into current mental health services in Australia. METHOD: The ICER of each of the family interventions is assessed from a health sector perspective, including the government, persons with schizophrenia and their families/carers using a standardized methodology. A two-stage approach is taken to the assessment of benefit. The first stage involves a quantitative analysis based on disability-adjusted life years (DALYs) averted. The second stage involves application of 'second filter' criteria (including equity, strength of evidence, feasibility and acceptability to stakeholders) to results. The robustness of results is tested using multivariate probabilistic sensitivity analysis. RESULTS: The most cost-effective intervention, in order of magnitude, is BIF (8000 Australian dollars per DALY averted), followed by MFG (21,000 Australian dollars per DALY averted) and lastly BFM (28,000 Australian dollars per DALY averted). The inclusion of time costs makes BFM more cost-effective than MFG. Variation of discount rate has no effect on conclusions. CONCLUSIONS: All three interventions are considered 'value-for-money' within an Australian context. This conclusion needs to be tempered against the methodological challenge of converting clinical outcomes into a generic economic outcome measure (DALY). Issues surrounding the feasibility of routinely implementing such interventions need to be addressed. pubtype: Academic Journal doctype: clinical trial equations & formulas research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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