When the cradle falls II: the cost-effectiveness of treating postnatal depression in a psychiatric day hospital compared with routine primary care

被引:19
作者
Boath, E
Major, K
Cox, J
机构
[1] Ayrshire & Arran Hlth Board, Hlth Policy Dept, Ayr, Scotland
[2] Keele Univ, Postgrad Med Sch, Keele, Staffs, England
关键词
postnatal depression; specialised psychiatric parent and baby day unit; routine primary care;
D O I
10.1016/S0165-0327(02)00007-1
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: This prospective cohort study assessed the cost-effectiveness of treating 30 women with postnatal depression (PND) at a specialised psychiatric Parent and Baby Day Unit (PBDU), compared to 30 women treated using routine primary care (RPC). Methods: Following recruitment, the women were assessed on three occasions (initially, 3- and 6-months), using a variety of social and psychiatric outcome measures. Direct and indirect costs were collated using structured interviews, retrospective analysis of case notes and routinely collated NHS cost data. Sensitivity analysis was also carried out. Results: There was no significant difference between the women in the two groups initially in terms of their socio-demographic characteristics, or scores on the outcome measures. However, at 6-months, 21 women in the PBDU group were no longer depressed compared to only seven women in the RPC group. The total cost was pound46 211 for the PBDU group and pound18 973 for the RPC group. Moving from RPC to a PBDU would involve an additional expenditure of pound27 238 (46 211-18 973) whilst delivering 14 more positive outcomes. The move from RPC to PBDU would incur an additional cost per successfully treated woman of pound1945 (27 238/14). This compares favourably with the current cost per successfully treated woman in the RPC group of pound2710 (18 973/7). Conclusions: RPC is dominated on the grounds of cost-effectiveness by PBDU treatment and so PBDU treatment should be recommended to health care decision-makers. Limitations of the study: The results were sensitive to the inclusion of primary care contacts and the costs of medication. (C) 2002 Elsevier Science B.V. All rights reserved.
引用
收藏
页码:159 / 166
页数:8
相关论文
共 36 条
[1]  
[Anonymous], 2021, RET WORK MENT HLTH I
[2]  
[Anonymous], UNIT COSTS COMMUNITY
[3]  
BALDESSARINI RJ, 1989, J CLIN PSYCHIAT, V50, P117
[4]   Analysis and interpretation of cost data in randomised controlled trials: review of published studies [J].
Barber, JA ;
Thompson, SG .
BRITISH MEDICAL JOURNAL, 1998, 317 (7167) :1195-1200
[5]   When the cradle falls: the treatment of postnatal depression in a psychiatric day hospital compared with routine primary care [J].
Boath, E ;
Cox, J ;
Lewis, M ;
Jones, P ;
Pryce, A .
JOURNAL OF AFFECTIVE DISORDERS, 1999, 53 (02) :143-151
[6]   The treatment of postnatal depression: a comprehensive literature review [J].
Boath, E ;
Henshaw, C .
JOURNAL OF REPRODUCTIVE AND INFANT PSYCHOLOGY, 2001, 19 (03) :215-248
[7]  
BOATH E, 1995, J REPROD INFANT PSYC, V13, P237
[8]  
BOATH E, 1999, MARCE SOC NEWSLETTER, V7, P3
[9]  
BOATH E, 1994, MARCE B AUT, P10
[10]  
BOATH EH, 1997, PARAPRAXIS, V3, P11