Health Economics Research Unit, Department of Psychiatry
Health Economics Research Unit, Department of Psychiatry, and Department of Medical Psychology and Medical Sociology
Health Economics Research Unit, Department of Psychiatry
Department of Psychiatry
Health Economics Research Unit, Department of Psychiatry
Public Health Research Unit, Department of Psychiatry
Department of Psychiatry, University of Leipzig, Germany
Center for Public Mental Health, Gösing am Wagram, Austria
Health Economics Research Unit, Department of Psychiatry, University of Leipzig, Germany
Correspondence: Hans-Helmut König, MPH, University of Leipzig, Health Economics Research Unit, Department of Psychiatry, Liebigstr. 26, D-04103 Leipzig, Germany. Email: hans-helmut.koenig{at}medizin.uni-leipzig.de
Background
Individuals with anxiety disorders often do not receive an accurate diagnosis or adequate treatment in primary care.
Aims
To analyse the cost-effectiveness of an optimised care model for people with anxiety disorders in primary care.
Method
In a cluster randomised controlled trial, 46 primary care practices with 389 individuals positively screened with anxiety were randomised to intervention (23 practices, 201 participants) or usual care (23 practices, 188 participants). Physicians in the intervention group received training on diagnosis and treatment of anxiety disorders combined with the offer of a psychiatric consultation–liaison service for 6 months. Anxiety, depression, quality of life, service utilisation and costs were assessed at baseline, 6-month and 9-month follow-up.
Results
No significant differences were observed between intervention and control
group on the Beck Anxiety Inventory, Beck Depression Inventory and EQ–5D
during follow-up. Total costs were higher in the intervention group
(
4911 v.
3453, P = 0.09). The probability of an
incremental cost-effectiveness ratio <
50 000 per quality-adjusted
life year was below 10%.
Conclusions
The optimised care model did not prove to be cost-effective.
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