Economic evaluation of a complex intervention to improve the mental health of maltreated children in foster care (BeST? Services trial)

被引：0

作者：

Deidda, Manuela ^{[1
]}

Minnis, Helen ^{[2
]}

Crawford, Karen ^{[2
]}

Young, Robin ^{[3
]}

Kainth, Gary ^{[2
]}

Donaldson, Julia ^{[4
]}

Forde, Matt ^{[4
]}

McConnachie, Alex ^{[3
]}

Gillberg, Christopher ^{[2
,5
,6
]}

Henderson, Marion ^{[7
,8
]}

Wilson, Philip ^{[9
,10
]}

Boyd, Kathleen A. ^{[1
]}

McIntosh, Emma ^{[1
]}

机构：

[1] Univ Glasgow, Sch Hlth & Wellbeing, Hlth Econ & Hlth Technol Assessment, Clarice Pears Bldg,90 Byres Rd, Glasgow G12 8TB, Scotland

[2] Univ Glasgow, Mental Hlth & Wellbeing, Sch Hlth & Wellbeing, Ctr Dev Advers & Resilience CeDAR, Clarice Pears Bldg,Level 2,90 Byres Rd, Glasgow G12 8TB, Scotland

[3] Univ Glasgow, Robertson Ctr Biostat, Sch Hlth & Wellbeing, Clarice Pears Bldg,90 Byres Rd, Glasgow City G12, Scotland

[4] Glasgow Infant & Family Team, NSPCC, Pavill 2 Rowan Business Pk Ardlaw St Glasgow, Glasgow G51 3RR, Scotland

[5] Univ Gothenburg, Gillberg Neuropsychiat Ctr, Gillbergcentrum Kungsgatan 12,van 2, S-41119 Gothenburg, Sweden

[6] Univ Gothenburg, Inst Neurosci & Physiol, Gillbergcentrum Kungsgatan 12,van 2, S-41119 Gothenburg, Sweden

[7] Univ Glasgow, Sch Hlth & Wellbeing, MRC CSO Social & Publ Hlth Sci Unit, Clarice Pears Bldg,90 Byres Rd, Glasgow G12 8TB, Scotland

[8] Univ Strathclyde, Sch Social Work & Social Policy, 141 St James Rd, Glasgow G4 0LT, Scotland

[9] Univ Aberdeen, Inst Appl Hlth Sci, Aberdeen AB24 3FX, Scotland

[10] Univ Copenhagen, Inst Publ Hlth Sci, Sect Gen Practice, Dept Hlth Sci,Dept Gen Practice, Oster Farimagsgade 5 opg, DK-Q1353 Copenhagen, Denmark

来源：

JOURNAL OF PUBLIC HEALTH | 2025年

关键词：

children; cost effectiveness; mental health; COST-EFFECTIVENESS ANALYSIS;

D O I：

10.1093/pubmed/fdaf038

中图分类号：

R1 [预防医学、卫生学];

学科分类号：

1004 ; 120402 ;

摘要：

Background Children in foster care who have experienced abuse and neglect are at risk of poor long-term health and societal outcomes. Evidence on the costs, benefits and cost-effectiveness of early interventions aimed at improving the mental health of abused and neglected children is limited.Methods This study reports the within-trial economic evaluation alongside BEST?, a randomized controlled trial comparing the New Orleans Intervention Model (NIM) with services as usual (SAU), targeting children aged 0-60 months entering UK foster care. In line with guidance for conducting economic evaluations of complex and social care interventions, a cost-utility analysis (CUA) estimated incremental cost of NIM per quality-adjusted life year (QALY); a cost-effectiveness analysis estimated incremental cost per unit improvement in child mental health; and a cost-consequence analysis combined costs with broad-ranging outcomes.Methods This study reports the within-trial economic evaluation alongside BEST?, a randomized controlled trial comparing the New Orleans Intervention Model (NIM) with services as usual (SAU), targeting children aged 0-60 months entering UK foster care. In line with guidance for conducting economic evaluations of complex and social care interventions, a cost-utility analysis (CUA) estimated incremental cost of NIM per quality-adjusted life year (QALY); a cost-effectiveness analysis estimated incremental cost per unit improvement in child mental health; and a cost-consequence analysis combined costs with broad-ranging outcomes.Results NIM is significantly more costly than SAU (NIM: 10 pound 002; SAU: 4336) pound, with wide cost variations according to context. There are no significant differences between NIM and SAU in QALYs or child mental health.Conclusions Within the current UK care systems, NIM is not a cost-effective alternative to SAU. However, these results need to be interpreted with caution and within the prevailing service provision context.

引用

页数：9

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