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Titolo:
The cost-utility of screening for depression in primary care
Autore:
Valenstein, M; Vijan, S; Zeber, JE; Boehm, K; Buttar, A;
Indirizzi:
Dept Vet Affairs Med Ctr, Hlth Serv Res & Dev, Ann Arbor, MI USA Dept Vet Affairs Med Ctr Ann Arbor MI USA v Res & Dev, Ann Arbor, MI USA Univ Michigan, Ann Arbor, MI 48109 USA Univ Michigan Ann Arbor MI USA 48109 iv Michigan, Ann Arbor, MI 48109 USA Med Coll Ohio, Toledo, OH 43699 USA Med Coll Ohio Toledo OH USA 43699Med Coll Ohio, Toledo, OH 43699 USA
Titolo Testata:
ANNALS OF INTERNAL MEDICINE
fascicolo: 5, volume: 134, anno: 2001,
pagine: 345 - 360
SICI:
0003-4819(20010306)134:5<345:TCOSFD>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
CASE-FINDING INSTRUMENTS; SEROTONIN REUPTAKE INHIBITORS; NATIONAL-COMORBIDITY-SURVEY; RANDOMIZED CLINICAL-TRIAL; TREATING MAJOR DEPRESSION; LATE-LIFE DEPRESSION; PRIMARY MEDICAL-CARE; QUALITY-OF-LIFE; MENTAL-DISORDERS; HEALTH-CARE;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
151
Recensione:
Indirizzi per estratti:
Indirizzo: Valenstein, M Dept Vet Affairs Med Ctr, Hlth Serv Res & Dev, Box 130170, Ann Arbor, MI USA Dept Vet Affairs Med Ctr Box 130170 Ann Arbor MI USA MI USA
Citazione:
M. Valenstein et al., "The cost-utility of screening for depression in primary care", ANN INT MED, 134(5), 2001, pp. 345-360

Abstract

Background: Depressive disorders are common in primary care and cause substantial disability, but they often remain undiagnosed. Screening is a frequently proposed strategy for increasing detection of depression. Objective: To examine the cost-utility of screening for depression compared with no screening. Design: Nonstationary Markov model. Data Sources: The published literature. Time Horizon: Lifetime. Perspective: Health care payer and societal. Interventions: Self-administered questionnaire followed by provider assessment. Outcome Measures: costs and quality-adjusted life-years (QALYs). Results of Base-Case Analysis: Compared with no screening, the cost to society of annual screening for depression in primary care patients is $192 444/QALY. Screening every 5 years and one-time screening cost $50 988/QALY and $32 053/QALY, respectively, compared with no screening. From the payer perspective, the cost of annual screening is $225 467. Results of Sensitivity Analyses: Cost-utility ratios are most sensitive tothe prevalence of major depression, the costs of screening, rates of treatment initiation, and remission rates with treatment. In Monte Carlo sensitivity analyses, the cost-utility of annual screening is less than $50 000/QALY only 2.2% of the time. In multiway analyses, four model variables must be changed to extreme values for the cost-utility of annual screening to fall below $50 000/QALY, but a change in only one variable increases the cost-utility of one-time screening to more than $50 000/QALY. One-time screeningis more robustly cost-effective if screening costs are low and effective treatments are being given. Conclusions: Annual and periodic screening for depression cost more than $50 000/QALY, but one-time screening is cost-effective. The cost-effectiveness of screening is likely to improve if treatment becomes more effective.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/04/20 alle ore 02:52:14