Evidence map›Paper›PMID 35440005›Full record

ArticleBMC health services research2022

Cost-effectiveness of a mental health drop-in centre for young people with long-term physical conditions.

Harrison Clarke, Walter Morris, Matteo Catanzano, Sophie Bennett, Anna E Coughtrey, Isobel Heyman, Holan Liang, Roz Shafran, Neha Batura

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.1field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 4 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Article
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Harrison Clarke *Institute for Global Health, University College London, London, UK.ORCID http://orcid.org/0000-0001-7341-4018
Walter Morris *Institute for Global Health, University College London, London, UK.ORCID http://orcid.org/0000-0001-6965-3518
Matteo CatanzanoUCL Great Ormond Street Institute of Child Health, University College London, London, UK.ORCID http://orcid.org/0000-0002-7876-4348
Sophie BennettUCL Great Ormond Street Institute of Child Health, University College London, London, UK.ORCID http://orcid.org/0000-0002-1076-7112
Anna E CoughtreyUCL Great Ormond Street Institute of Child Health, University College London, London, UK.
Isobel HeymanUCL Great Ormond Street Institute of Child Health, University College London, London, UK.ORCID http://orcid.org/0000-0001-7358-9766
Holan LiangUCL Great Ormond Street Institute of Child Health, University College London, London, UK.
Roz ShafranUCL Great Ormond Street Institute of Child Health, University College London, London, UK.ORCID http://orcid.org/0000-0003-2729-4961
Neha BaturaInstitute for Global Health, University College London, London, UK. n.batura@ucl.ac.uk.ORCID http://orcid.org/0000-0002-8175-8125
Great Ormond Street Hospital for Children NHS Foundation Trust · GBUniversity College London · GB

Funding

Beryl Alexander Charity and the Great Ormond Street Hospital Children's Charity W1132
6 · The paper itself

Abstract

backgroundPaediatric patients being treated for long-term physical health conditions (LTCs) have elevated mental health needs. However, mental health services in the community are difficult to access in the usual course of care for these patients. The Lucy Project - a self-referral drop-in access point-was a program to address this gap by enrolling patients for low-intensity psychological interventions during their treatment for LTCs. In this paper, we evaluate the cost-effectiveness of the Lucy Project.

methodsUsing a pre-post design, we evaluate the cost-effectiveness of the intervention by calculating the base-case incremental cost-effectiveness ratio (ICER) using outcomes data and expenses recorded by project staff. The target population was paediatric patients enrolled in the program with an average age of 9 years, treated over a time horizon of 6 months. Outcome data were collected via the Paediatric Quality of Life Inventory, which was converted to health utility scores using an instrument found in the literature. The QALYs were estimated using these health utility scores and the length of the intervention. We calculate a second, practical-case incremental cost-effectiveness ratio using streamlined costing figures with maximum capacity patient enrolment within a one-year time horizon, and capturing lessons learned post-trial.

resultsThe base-case model showed an ICER of £21,220/Quality Adjusted Life Years (QALY) gained, while the practical model showed an ICER of £4,359/QALY gained. The practical model suggests the intervention garners significant gains in quality of life at an average cost of £309 per patient. Sensitivity analyses reveal use of staff time was the greatest determinant of the ICER, and the intervention is cost-effective 75% of the time in the base-case model, and 94% of the time in the practical-case model at a cost-effectiveness threshold of £20,000/QALY gained.

conclusionsWe find the base-case intervention improves patient outcomes and can be considered cost-effective according to the National Institute for Health and Care Excellence (NICE) threshold of £20,000-£30,000/QALY gained, and the practical-case intervention is roughly four times as cost-effective as the base-case. We recommend future studies incorporate a control group to corroborate the effect size of the intervention.

Indexed as

Mental HealthQuality of LifeAdolescentChildCost-Benefit AnalysisHumansQuality-Adjusted Life YearsChild and adolescent mental healthCost-effectiveness analysisEconomic evaluationLong-term physical health

Identifiers

PMID35440005
PMCPMC9016208
OpenAlexW4224297353

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.