PDF(Pubmed)
Abstract：
Mental health conditions are among the highest disease burden on society, affecting approximately 20% of children and adolescents at any point in time, with depression and anxiety being the leading causes of disability globally. To improve treatment outcomes, healthcare organizations turned to clinical decision support systems (CDSSs) that offer patient-specific diagnoses and recommendations. However, the economic impact of CDSS is limited, especially in child and adolescent mental health. This systematic literature review examined the economic impacts of CDSS implemented in mental health services. We planned to follow PRISMA reporting guidelines and found only one paper to describe health and economic outcomes. A randomized, controlled trial of 336 participants found that 60% of the intervention group and 32% of the control group achieved symptom reduction, i.e. a 50% decrease as per the Symptom Checklist-90-Revised (SCL-90-R), a method to evaluate psychological problems and identify symptoms. Analysis of the incremental cost-effectiveness ratio found that for every 1% of patients with a successful treatment result, it added €57 per year. There are not enough studies to draw conclusions about the cost-effectiveness in a mental health context. More studies on economic evaluations of the viability of CDSS within mental healthcare have the potential to contribute to patients and the larger society.
摘要：
精神卫生状况是社会负担最高的疾病之一，在任何时间点影响大约20%的儿童和青少年，抑郁和焦虑是全球残疾的主要原因。为了改善治疗结果，医疗保健组织转向提供患者特异性诊断和建议的临床决策支持系统(CDS).然而,CDSS的经济影响是有限的，特别是在儿童和青少年心理健康方面。这篇系统的文献综述研究了在精神卫生服务中实施CDSS的经济影响。我们计划遵循PRISMA报告指南，发现只有一篇论文描述健康和经济结果。一个随机的，336名参与者的对照试验发现，60%的干预组和32%的对照组实现了症状减轻，即根据症状检查表-90-修订版(SCL-90-R)减少50%,一种评估心理问题和识别症状的方法。增量成本-效果比分析发现,每1%的患者治疗成功,它每年增加57欧元。没有足够的研究来得出关于心理健康背景下的成本效益的结论。关于CDSS在精神医疗保健中的可行性的经济评估的更多研究有可能为患者和更大的社会做出贡献。
