University of Twente Student Theses


Kosten-effectiviteitsanalyses en de cursus ‘Geen Paniek’

Boonk, Esther (2012) Kosten-effectiviteitsanalyses en de cursus ‘Geen Paniek’.

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Abstract:Background - In somatic and mental health care some important aspects are involved in the choice of an appropriate intervention. Besides the importance of the effectiveness of the intervention, the costs of such interventions also increased substantially in recent years, thereby arising more interest for the cost-effectiveness. Economic evaluation examines the relationship between effects and resources. The main aspects of the cost-effectiveness analyses are explained here. We also examined the current state of affairs in the field of economic evaluation in the health care area. Also there was a cost-effectiveness analysis of preventive and early intervention 'Don’t panic' conducted. Smit e.a. (2009) already showed that the intervention appears to be cost-effective in the field of prevention. Methods - A total of 217 participants participated in the randomized controlled trial (RCT), in which 109 participants were assigned to the intervention and 108 participants to the waiting list (care-as-usual). The primary outcome measure was whether or not having a panic disorder according to the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) at follow-up measured with the Mini International Neuropsychiatric Interview Plus (MINI-Plus). As a secondary outcome measure was a clinically significant change on the Panic Disorder Severity Scale (PDSS-SR) used. All costs were included in the analysis from the societal perspective. Results - The median incremental cost-effectiveness ratio (ICER) is €6.503 (95% CI 3.395 – 29.517) per success on the MINI/DSM-IV, which has a likelihood of 79% of being more acceptable from a cost-effectiveness point of view than care-as-usual when a willingness-topay ceiling is assumed of €10.000. The most significant cost driver was therapists' time. A sensitivity analysis indicated that cost-effectiveness improves when the number of therapist hours is reduced. Conclusion - The results show that the intervention in addition to the previously proven cost-effectiveness in the field of prevention (Smit e.a., 2009), appears to be cost-effective when it comes to prevention and treatment of panic disorder. When the time invested by therapists is reduced to a minimum, the cost-effectiveness will increase further. The results are promising. It is recommended that the study will be replicated in a RCT with a longer follow-up period of both conditions and continue with the implementation of the intervention.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:77 psychology
Programme:Psychology MSc (66604)
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