Cost-effectiveness of a mental health drop-in centre for young people with long-term physical conditions.

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Tytuł:: Cost-effectiveness of a mental health drop-in centre for young people with long-term physical conditions.
Autorzy:: Clarke H; Institute for Global Health, University College London, London, UK.
Morris W; Institute for Global Health, University College London, London, UK.
Catanzano M; UCL Great Ormond Street Institute of Child Health, University College London, London, UK.; Psychological and Mental Health Services, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK.
Bennett S; UCL Great Ormond Street Institute of Child Health, University College London, London, UK.; Psychological and Mental Health Services, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK.
Coughtrey AE; UCL Great Ormond Street Institute of Child Health, University College London, London, UK.; Psychological and Mental Health Services, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK.
Heyman I; UCL Great Ormond Street Institute of Child Health, University College London, London, UK.; Psychological and Mental Health Services, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK.
Liang H; UCL Great Ormond Street Institute of Child Health, University College London, London, UK.; Psychological and Mental Health Services, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK.
Shafran R; UCL Great Ormond Street Institute of Child Health, University College London, London, UK.; Psychological and Mental Health Services, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK.
Batura N; Institute for Global Health, University College London, London, UK. .
Źródło:: BMC health services research [BMC Health Serv Res] 2022 Apr 19; Vol. 22 (1), pp. 518. Date of Electronic Publication: 2022 Apr 19.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Original Publication: London : BioMed Central, [2001-
MeSH Terms:: Mental Health*
Quality of Life*
Adolescent ; Child ; Cost-Benefit Analysis ; Humans ; Quality-Adjusted Life Years
References:: J Pediatr Psychol. 2011 Oct;36(9):1003-16. (PMID: 21810623)
Med Care. 2001 Aug;39(8):800-12. (PMID: 11468499)
J Diabetes Complications. 2005 Mar-Apr;19(2):113-22. (PMID: 15745842)
Shanghai Arch Psychiatry. 2013 Apr;25(2):68-9. (PMID: 24991137)
J Paediatr Child Health. 2011 Oct;47(10):742-7. (PMID: 21449905)
Eur Child Adolesc Psychiatry. 2022 Jun;31(6):879-889. (PMID: 33492480)
BMJ. 1999 Jun 5;318(7197):1551-2. (PMID: 10356019)
Pharmacoeconomics. 2014 Jul;32(7):693-706. (PMID: 24715604)
Pak J Med Sci. 2020 May;36(COVID19-S4):S67-S72. (PMID: 32582317)
Acad Pediatr. 2019 Jan - Feb;19(1):44-50. (PMID: 30315948)
Acta Paediatr. 2011 Aug;100(8):1069-76. (PMID: 21332786)
Diabetes Care. 1995 Dec;18(12):1592-9. (PMID: 8722057)
J Child Adolesc Trauma. 2018 Jun 28;13(1):1-10. (PMID: 32318223)
J Dev Behav Pediatr. 2008 Oct;29(5):394-402. (PMID: 18714205)
BMJ. 2012 Jun 19;344:e4250. (PMID: 22718919)
Arch Dis Child. 2015 Apr;100(4):303-4. (PMID: 25784735)
J Am Acad Child Adolesc Psychiatry. 2019 Jan;58(1):61-71. (PMID: 30577940)
Pharmacoeconomics. 1999 Nov;16(5 Pt 1):449-58. (PMID: 10662392)
Clin Child Psychol Psychiatry. 2020 Jul;25(3):594-603. (PMID: 32046508)
BMJ Open. 2020 Sep 15;10(9):e040620. (PMID: 32933965)
Int J Environ Res Public Health. 2021 May 18;18(10):. (PMID: 34069973)
Health Technol Assess. 2019 May;23(22):1-164. (PMID: 31122334)
Evid Based Ment Health. 2021 Feb;24(1):25-32. (PMID: 33243761)
Clin Pediatr (Phila). 2019 Sep;58(10):1078-1084. (PMID: 31303026)
Pharmacoeconomics. 2008;26(9):733-44. (PMID: 18767894)
Aust N Z J Psychiatry. 2013 Sep;47(9):849-58. (PMID: 23719183)
Pediatrics. 2019 Jul;144(1):. (PMID: 31201229)
J Pediatr Psychol. 2011 May;36(4):375-84. (PMID: 21088072)
JAMA Psychiatry. 2013 Jul;70(7):750-61. (PMID: 23754332)
Pediatrics. 2016 Nov;138(5):. (PMID: 27940773)
Diabetes Educ. 2017 Jun;43(3):251-259. (PMID: 28520550)
Br J Psychiatry. 2006 Jun;188:547-53. (PMID: 16738345)
Lancet Psychiatry. 2016 Feb;3(2):137-44. (PMID: 26777773)
J Child Psychol Psychiatry. 1997 Jul;38(5):581-6. (PMID: 9255702)
Front Psychol. 2015 Nov 25;6:1713. (PMID: 26635648)
Cost Eff Resour Alloc. 2020 Aug 27;18:29. (PMID: 32874138)
J Child Psychol Psychiatry. 2019 Aug;60(8):828-847. (PMID: 30775782)
Arch Dis Child. 2022 Mar;107(3):e2. (PMID: 34045207)
Grant Information:: W1132 Beryl Alexander Charity and the Great Ormond Street Hospital Children's Charity; W1132 Beryl Alexander Charity and the Great Ormond Street Hospital Children's Charity; W1132 Beryl Alexander Charity and the Great Ormond Street Hospital Children's Charity; W1132 Beryl Alexander Charity and the Great Ormond Street Hospital Children's Charity; W1132 Beryl Alexander Charity and the Great Ormond Street Hospital Children's Charity; W1132 Beryl Alexander Charity and the Great Ormond Street Hospital Children's Charity; W1132 Beryl Alexander Charity and the Great Ormond Street Hospital Children's Charity; W1132 Beryl Alexander Charity and the Great Ormond Street Hospital Children's Charity; W1132 Beryl Alexander Charity and the Great Ormond Street Hospital Children's Charity
Contributed Indexing:: Keywords: Child and adolescent mental health; Cost-effectiveness analysis; Economic evaluation; Long-term physical health
Entry Date(s):: Date Created: 20220420 Date Completed: 20220421 Latest Revision: 20220716
Update Code:: 20240104
PubMed Central ID:: PMC9016208
DOI:: 10.1186/s12913-022-07901-x
PMID:: 35440005
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Background: Paediatric patients being treated for long-term physical health conditions (LTCs) have elevated mental health needs. However, mental health services in the community are difficult to access in the usual course of care for these patients. The Lucy Project - a self-referral drop-in access point-was a program to address this gap by enrolling patients for low-intensity psychological interventions during their treatment for LTCs. In this paper, we evaluate the cost-effectiveness of the Lucy Project.
Methods: Using a pre-post design, we evaluate the cost-effectiveness of the intervention by calculating the base-case incremental cost-effectiveness ratio (ICER) using outcomes data and expenses recorded by project staff. The target population was paediatric patients enrolled in the program with an average age of 9 years, treated over a time horizon of 6 months. Outcome data were collected via the Paediatric Quality of Life Inventory, which was converted to health utility scores using an instrument found in the literature. The QALYs were estimated using these health utility scores and the length of the intervention. We calculate a second, practical-case incremental cost-effectiveness ratio using streamlined costing figures with maximum capacity patient enrolment within a one-year time horizon, and capturing lessons learned post-trial.
Results: The base-case model showed an ICER of £21,220/Quality Adjusted Life Years (QALY) gained, while the practical model showed an ICER of £4,359/QALY gained. The practical model suggests the intervention garners significant gains in quality of life at an average cost of £309 per patient. Sensitivity analyses reveal use of staff time was the greatest determinant of the ICER, and the intervention is cost-effective 75% of the time in the base-case model, and 94% of the time in the practical-case model at a cost-effectiveness threshold of £20,000/QALY gained.
Conclusions: We find the base-case intervention improves patient outcomes and can be considered cost-effective according to the National Institute for Health and Care Excellence (NICE) threshold of £20,000-£30,000/QALY gained, and the practical-case intervention is roughly four times as cost-effective as the base-case. We recommend future studies incorporate a control group to corroborate the effect size of the intervention.
(© 2022. The Author(s).)

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