中国卫生产业
中國衛生產業
중국위생산업
CHINA HEALTH INDUSTRY
2014年
21期
43-45
,共3页
孙一颖%陈定华%孙喜蓉%梅久红%张明%傅伟忠
孫一穎%陳定華%孫喜蓉%梅久紅%張明%傅偉忠
손일영%진정화%손희용%매구홍%장명%부위충
心境-促进协作医疗%老年抑郁症%生活质量%卫生经济
心境-促進協作醫療%老年抑鬱癥%生活質量%衛生經濟
심경-촉진협작의료%노년억욱증%생활질량%위생경제
Improving Mood-Promoting Access to Collaborative Treatment (IMPACT)%Collaborative care management%Late-life depression%Preliminary health economy
目的：探讨“心境-促进协作医疗”（IMPACT）管理模式对社区老年抑郁症患者生活质量影响及卫生经济学价值。方法对30名社区老年抑郁症患者实施为期2年的IMPACT管理治疗，按1：1配对另30例作为对照组，对其实施常规的社区精神病康复管理。在干预第一年末及第二年末使用汉密尔顿量表（HAMD）、家庭负担表（FIS）、生活满意度（LSR）进行评定并观察费用成本。结果在实施干预的第一年末和第二年末,干预组患者的HAMD和FIS得分较对照组显著降低、干预组患者LSR得分较对照组显著升高（列联表卡方检验结果中，χ2均大于5.9，P值均<0.05）。2年内干预组患者总费用低于对照组，表现在门诊费用、住院费用、社区防治费用和家属误工费用等方面干预者患者的支出要明显少于对照组患者（t检验结果中，P值均<0.05）；同时，两者患者在药物费用支出方面无显著差异。结论 IMPACT管理模式能有效减轻社区老年抑郁症患者的抑郁症状，并显著降低患者因疾病产生的各项费用成本。
目的：探討“心境-促進協作醫療”（IMPACT）管理模式對社區老年抑鬱癥患者生活質量影響及衛生經濟學價值。方法對30名社區老年抑鬱癥患者實施為期2年的IMPACT管理治療，按1：1配對另30例作為對照組，對其實施常規的社區精神病康複管理。在榦預第一年末及第二年末使用漢密爾頓量錶（HAMD）、傢庭負擔錶（FIS）、生活滿意度（LSR）進行評定併觀察費用成本。結果在實施榦預的第一年末和第二年末,榦預組患者的HAMD和FIS得分較對照組顯著降低、榦預組患者LSR得分較對照組顯著升高（列聯錶卡方檢驗結果中，χ2均大于5.9，P值均<0.05）。2年內榦預組患者總費用低于對照組，錶現在門診費用、住院費用、社區防治費用和傢屬誤工費用等方麵榦預者患者的支齣要明顯少于對照組患者（t檢驗結果中，P值均<0.05）；同時，兩者患者在藥物費用支齣方麵無顯著差異。結論 IMPACT管理模式能有效減輕社區老年抑鬱癥患者的抑鬱癥狀，併顯著降低患者因疾病產生的各項費用成本。
목적：탐토“심경-촉진협작의료”（IMPACT）관리모식대사구노년억욱증환자생활질량영향급위생경제학개치。방법대30명사구노년억욱증환자실시위기2년적IMPACT관리치료，안1：1배대령30례작위대조조，대기실시상규적사구정신병강복관리。재간예제일년말급제이년말사용한밀이돈량표（HAMD）、가정부담표（FIS）、생활만의도（LSR）진행평정병관찰비용성본。결과재실시간예적제일년말화제이년말,간예조환자적HAMD화FIS득분교대조조현저강저、간예조환자LSR득분교대조조현저승고（렬련표잡방검험결과중，χ2균대우5.9，P치균<0.05）。2년내간예조환자총비용저우대조조，표현재문진비용、주원비용、사구방치비용화가속오공비용등방면간예자환자적지출요명현소우대조조환자（t검험결과중，P치균<0.05）；동시，량자환자재약물비용지출방면무현저차이。결론 IMPACT관리모식능유효감경사구노년억욱증환자적억욱증상，병현저강저환자인질병산생적각항비용성본。
Objective To discuss the effectiveness of the IMPACT collaborative care management program on life quality of late-life depression in primary care and preliminary health economy analysis. Methods 30 elderly depressions as the intervention group patients were treated by 2 years’IMPACT collaborative care. Another 30 elderly depressions were chosen as the control group pa-tients by 1:1 matching. They were treated by general care. Effectiveness was assessed by using the Hamilton Depression Scale (HAMD), Family Interview Schedule(FIS), Life Satisfaction Rating Scale (LSR) 1 year and 2 years after intervention; And the costs were observed at the time. Results The HAMD and FIS scores in intervention group were significantly lower than those in control group at the time of 1 year and 2 years after intervention, The LSR score was higher than those in control group (χ2>5.9,P<0.05). The two years’costs were less in the intervention group, especially that on out-patient service, hospitalization, community interven-tion and treatment, and work loss of caregivers (P<0.05), there’s no difference on medical treatment between two groups Conclu-sion The Improving Mood-Promoting Access to Collaborative Treatment (IMPACT) collaborative care management program for late-life depression could relieve the depressive symptoms effectively with less cost.
