藥癮減害執行成效評估之探討

CMUR > College of Public Health > Department and Graduate of Health Services Administration > Research reports > Item 310903500/11423

Please use this identifier to cite or link to this item: http://ir.cmu.edu.tw/ir/handle/310903500/11423

Title:	藥癮減害執行成效評估之探討
Authors:	馬作鏹(Ma Tsochiang)
Contributors:	公共衛生學院醫務管理學系
Keywords:	藥癮戒治;成本效果;成癮嚴重度指標;生活品質;drug abuse treatment;cost-effectiveness;addiction severity index;quality of life
Date:	2009-12-31
Issue Date:	2009-09-01 15:12:05 (UTC+8)
Abstract:	藥物濫用及成癮為當今重要的社會問題。在台灣，藥物濫用罪犯逐年成長，且再犯的機率高。目前已發展許多藥癮戒治模式，美沙冬替代療法為其中較具效益且廣泛被使用來藥癮戒治。然而在台灣此替代療法成本效能資料是闕如的。因此，為使醫療資源獲得最適利用，建構國內藥物戒治的成本效能模式勢在必行。本研究之目的使用成本效果分析來建構成本效能評估模型，作為國內各種不同藥癮治療模式的戒治成效評估依據。本研究採用前瞻式研究設計，研究對象為美沙冬替代療法之病患，採用之研究工具有：成癮嚴重度指標(Addiction Severity Index, ASI)、生活品質量表(Short Form-36, SF-36)。成癮嚴重度指標(ASI)用來評估臨床療效，生活品質量表(Short Form-36, SF-36)則用來進行生活品質的評估。前測納入630位個案，持續2個月追蹤，直至後測共收集有效個案452位，平均年齡為37.9歲，男性佔81.0%。逐一評估直接、間接、生產力損失，可得到每位藥癮患者戒治2個月總戒治成本為66,777.7元。以成癮嚴重度(ASI)及生活品質(SF-36)之效果比值來看，短期內若要改善藥癮病患一單位的藥物使用嚴重度，需花29,033.78元，而要改善藥癮病患一單位的生活品質，需花10,770.60元。此成本效果結果可提供給醫藥衛生政策及相關人員具體建議之依據。 Drug abuse is now one of the most serious social problems. The rate of drug abuse criminal had grown and the average recurrence rate of treatment for drug abuser was high in Taiwan. Therefore, how to effectively treat drug abuser becomes urgent issue for policy makers and health care providers. Currently, several treatment modalities have been developed. Methadone maintenance is an effective, accepted, and widely used treatment for drug abuse. In order to efficiently allocate health care resource, health care researchers have to evaluate those modalities properly. The aim of this study is to evaluate methadone maintenance treatment modality by using cost-effectiveness analysis. Our research is a prospective study. Subjects were methadone- maintenanced patients and were included into our study from May 2009 and October 2009. Addiction Severity Index (ASI) and Short Form-36 (SF-36) were utilized to collect data. Total 630 subjects were recruited during this period. 452 subjects of them have finished 2-month follow-up. The average age of subjects was 37.9 years. Subjects were 81.0% male. Out study revealed that the average costs for treating each drug abuser were estimated NT $66,777.7. In addition, it costs as NT $29,033.78 to improve one unit of drug abuse severity for two months treatments. In terms of the quality of life, our study found that NT $10,770.60 is needed to improve one unit for drug abusers. Given prior evidence of effectiveness, these cost data may be useful to policy makers, social service agencies.
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