Manuela Deidda, Helen Minnis, Karen Crawford, Robin Young, Gary Kainth, Julia Donaldson, Matt Forde, Alex McConnachie, Christopher Gillberg, Marion Henderson, Philip Wilson, Kathleen A Boyd, Emma McIntosh
{"title":"改善寄养中受虐待儿童心理健康的综合干预的经济评价(BeST?服务审判)。","authors":"Manuela Deidda, Helen Minnis, Karen Crawford, Robin Young, Gary Kainth, Julia Donaldson, Matt Forde, Alex McConnachie, Christopher Gillberg, Marion Henderson, Philip Wilson, Kathleen A Boyd, Emma McIntosh","doi":"10.1093/pubmed/fdaf038","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>NIM is significantly more costly than SAU (NIM: £10 002; SAU: £4336), with wide cost variations according to context. There are no significant differences between NIM and SAU in QALYs or child mental health.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":94107,"journal":{"name":"Journal of public health (Oxford, England)","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Economic evaluation of a complex intervention to improve the mental health of maltreated children in foster care (BeST? Services trial).\",\"authors\":\"Manuela Deidda, Helen Minnis, Karen Crawford, Robin Young, Gary Kainth, Julia Donaldson, Matt Forde, Alex McConnachie, Christopher Gillberg, Marion Henderson, Philip Wilson, Kathleen A Boyd, Emma McIntosh\",\"doi\":\"10.1093/pubmed/fdaf038\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>NIM is significantly more costly than SAU (NIM: £10 002; SAU: £4336), with wide cost variations according to context. There are no significant differences between NIM and SAU in QALYs or child mental health.</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":94107,\"journal\":{\"name\":\"Journal of public health (Oxford, England)\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-04-06\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of public health (Oxford, England)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1093/pubmed/fdaf038\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of public health (Oxford, England)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/pubmed/fdaf038","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Economic evaluation of a complex intervention to improve the mental health of maltreated children in foster care (BeST? Services trial).
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.
Results: NIM is significantly more costly than SAU (NIM: £10 002; SAU: £4336), 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.