分区化管治社区精神分裂症的效果及成本/效益分析

An analysis on the cost-benefit and efficacy of sectorizational supervision and treatment in the community based for schizophrenia

目的探讨分区化管治对社区精神分裂症患者的康复效益及降低康复费用的作用.方法对278例社区精神分裂症患者实施分区化管治,分析管治前后的治疗情况、病情变化、社会功能和社会影响,与79例未实施分区化管治的患者对照,并进行了卫生经济状况对照分析.结果分区化管治效果显著,研究组新参加康复的人数和新增参与率、显著高于对照组(P＜0.05～0.01),而复发/恶化率逐年对比显著低于对照组(P＜0.05～0.01),研究组的社会功能优于对照组而社会影响显著小于对照组(P＜0.01),研究组平均年直接费用减少916元,间接费用减少564元,复工增加收入616元,效益(复工增加收入)与社区干预投入费用的比值为2.25.结论分区化管治模式可充分发挥专业技术队伍和社会支持系统的作用,明显提高康复效果和减少资源浪费,适合我国国情,有利于社区精神分裂症患者的康复.

Objective To explore the efficacy of sectorizational supervision and treatment in increasing benefit and decreasing cost for community schizophrenic patients.Methods 278 cases with schizophrenia in community based were managed and treatment with sectorization program. The treatmemt, ill-condition, social function and social effects were investigated and compared with before and after sectorization program. The results also were compared with the control group(79cases),and were analyzed on health economy.Results The sectorization program showed significantly better efficacy. The increasing participator rate of the study group showed significantly higher than that of the control(P<0.05～0.01),but the re-onset/worse rate showed yearly lower than that of the control(P<0.05～0.01).The study group had better social function and less social effects than the control group(P<0.01).The study group yearly reduced direct cost by 916 yuan and indirect cose by 564 yuan with the income increasing 616 yuan. The ratio of benefit to input was 2.25.Conclusion The model sectorizational supervision and treatment could play an important role of personnel and social support. It satisfied to our country and helped to improve rehabilitation for community schizophrenia by enhancing efficacy and reducing resourse waste.