|Title:||Cost-effectiveness and Cost-Utility Analysis of Outpatient Follow-Up Frequency in Relation to Three-Year Mortality in Discharged Patients With Bipolar Disorder||Authors:||Yi-Ju Pan
|Keywords:||bipolar disorder;Cost-effectiveness;Cost-utility;mortality;Outpatient follow-up||Issue Date:||Feb-2019||Journal:||Psychiatry Research||Journal Issue:||272||Journal Pages:||61-68||Abstract:||There is a lack of clarity in terms of cost-effectiveness and cost-utility comparisons across different outpatient (OPD) follow-up patterns in discharged patients with bipolar disorder (BD). In this study, adult patients hospitalised for BD treatment (n = 1,591) were identified from the National Health Insurance Research Database in Taiwan. With survival as the effectiveness measure and quality-adjusted life years (QALYs) as the utility measure, a cost-effectiveness and cost-utility analysis was conducted over the 3-year follow-up period by post-discharge frequency of OPD visits. Compared to those making 1-7, 8-12 and 18 or more OPD visits, BD patients making 13-17 OPD visits within the first year after discharge had the lowest psychiatric and total healthcare costs over the follow-up period. With survival status as the effectiveness outcome, making 13-17 OPD visits was more likely to be the cost-effective option, as revealed by incremental cost-effectiveness ratios. Cost-utility analysis demonstrated that having 13-17 OPD visits was probably the more cost-effective option when considering QALYs; for instance, if society was willing to pay NTD1.5 million for one additional QALY, there was a 75.2% (psychiatric costs) to 77.4% (total costs) likelihood that 13-17 OPD visits was the most cost-effective option. In conclusion, post-discharge OPD appointments with a frequency of 13-17 visits within the first year were associated with lower psychiatric and total healthcare costs in the subsequent 3 years. Having an adequate outpatient follow-up frequency was likely to be cost-effective in the management of discharged patients with BD in this real-world setting.||URI:||http://172.27.2.131/handle/123456789/944||DOI:||10.1016/j.psychres.2018.12.067|
|Appears in Collections:||社會企業與創新碩士學位學程|
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