本文選題：社區(qū)精神衛(wèi)生服務(wù) + 精神分裂癥��； 參考：《中國全科醫(yī)學(xué)》2014年32期

【摘要】：目的探討積極性社區(qū)干預(yù)治療精神分裂癥患者的成本-效果。方法選取2012年12月—2013年2月無錫市南長區(qū)重性精神病規(guī)范化管理的慢性精神分裂癥患者120例,使用隨機(jī)數(shù)字表法將其均分為研究組和對照組,研究組給予積極性社區(qū)干預(yù),對照組提供常規(guī)社區(qū)精神衛(wèi)生服務(wù),隨訪觀察1年。采用自制社區(qū)精神疾病成本調(diào)查表、陽性與陰性癥狀量表(PANSS)、世界衛(wèi)生組織生命質(zhì)量測定量表簡表(WHOQOL-BREF)對兩組患者的治療成本-效果進(jìn)行評估。結(jié)果兩組患者的性別構(gòu)成、年齡、首次發(fā)病年齡、婚姻狀態(tài)、受教育年限、病程、住院次數(shù)、藥物劑量、家庭月收入、服藥依從性、主要照顧者情況比較,差異均無統(tǒng)計學(xué)意義(P0.05)。兩組總成本比較,差異無統(tǒng)計學(xué)意義(P0.05)。研究組社區(qū)精神病防治費(fèi)用、住院費(fèi)用、住院探視交通費(fèi)用、家屬照顧缺勤費(fèi)用低于對照組,差異有統(tǒng)計學(xué)意義(P0.05)。干預(yù)前兩組患者PANSS得分、WHOQOL-BREF得分比較,差異均無統(tǒng)計學(xué)意義(P0.05)。干預(yù)后1年時兩組PANSS評分減分量(E1)、WHOQOL-BREF評分增分量(E2)比較,差異均有統(tǒng)計學(xué)意義(P0.05)。分別以PANSS得分、WHOQOL-BREF得分為治療效果進(jìn)行成本-效果分析,PANSS評分每減少1分、WHOQOL-BREF評分每增加1分,研究組的平均成本-效果比(C/E1和C/E2)均低于對照組。敏感性分析顯示,假設(shè)總成本下降10%而E1、E2維持不變時,研究組的成本-效果仍低于對照組。結(jié)論積極性社區(qū)干預(yù)能有效改善慢性精神分裂癥患者的臨床癥狀和生活質(zhì)量,較傳統(tǒng)社區(qū)衛(wèi)生服務(wù)更具有衛(wèi)生經(jīng)濟(jì)學(xué)價值,是一種經(jīng)濟(jì)有效的社區(qū)康復(fù)模式,值得推廣應(yīng)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.
【作者單位】： 南京醫(yī)科大學(xué)附屬無錫精神衛(wèi)生中心;無錫市南長區(qū)社區(qū)衛(wèi)生服務(wù)中心;
【分類號】：R749.3

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本文編號：1916057