OBJECTIVE:To determine the 12-month cost-effectiveness of a collaborative care (CC) program for treating depression following coronary artery bypass graft (CABG) surgery versus physicians' usual care (UC). METHODS:We obtained 12 continuous months of Medicare and private medical insurance claims data on 189 patients who screened positive for depression following CABG surgery, met criteria for depression when reassessed by telephone 2 weeks following hospitalization (nine-item Patient Health Questionnaire ≥10) and were randomized to either an 8-month centralized, nurse-provided and telephone-delivered CC intervention for depression or to their physicians' UC. RESULTS:At 12 months following randomization, CC patients had $2068 lower but statistically similar estimated median costs compared to UC (P=.30) and a variety of sensitivity analyses produced no significant changes. The incremental cost-effectiveness ratio of CC was -$9889 (-$11,940 to -$7838) per additional quality-adjusted life-year (QALY), and there was 90% probability it would be cost-effective at the willingness to pay threshold of $20,000 per additional QALY. A bootstrapped cost-effectiveness plane also demonstrated a 68% probability of CC "dominating" UC (more QALYs at lower cost). CONCLUSIONS:Centralized, nurse-provided and telephone-delivered CC for post-CABG depression is a quality-improving and cost-effective treatment that meets generally accepted criteria for high-value care.

译文

目的:确定协作治疗(CC)方案治疗冠状动脉搭桥术(CABG)术后相对于医生的常规治疗(UC)抑郁症的12个月成本效益。
方法:我们获得了连续12个月的医疗保险和私人医疗保险理赔数据,这些数据包括189例CABG术后抑郁症呈阳性的患者,住院2周后通过电话重新评估符合抑郁症的标准(9项患者健康问卷≥10),以及被随机分配到为期8个月的集中式,由护士提供并通过电话进行的抑郁症CC干预或医生的UC。
结果:在随机分组后的12个月,CC患者的费用中位数比UC低2068美元,但统计学上相似(P = .30),并且各种敏感性分析均未见明显变化。每增加一个质量调整生命周期(QALY),CC的成本效益比为-9889美元(-$ 11,940到-$ 7838),并且在愿意支付20,000美元的门槛时,有90%的可能性具有成本效益。每增加一个QALY。自举成本效益飞机还证明了CC“主导” UC的可能性为68%(以较低的成本获得更多的QALY)。
结论:集中的,由护士提供的和电话提供的CC-CABG后抑郁症治疗是一种质量改善且具有成本效益的治疗方法,符合公认的高价值护理标准。

+1
+2
100研值 100研值 ¥99课程
检索文献一次
下载文献一次

去下载>

成功解锁2个技能,为你点赞

《SCI写作十大必备语法》
解决你的SCI语法难题!

技能熟练度+1

视频课《玩转文献检索》
让你成为检索达人!

恭喜完成新手挑战

手机微信扫一扫,添加好友领取

免费领《Endnote文献管理工具+教程》

微信扫码, 免费领取

手机登录

获取验证码
登录