北台灣美沙冬治療的效益分析

The Effectiveness of Methadone Maintenance Treatment in Northern Taiwan

周盈君(YING-CHUN CHOU)

指導教授 ： 李思賢

國立臺灣師範大學/教育學院/健康促進與衛生教育學系/碩士(2012年)

摘要

Objective: This paper examined the costs and the effectiveness before the Methadone Maintenance Treatment (MMT) and after one-year follow-up of MMT from patients’ perspective in four hospitals in northern Taiwan.

Methods: The participants in this study were recruited from the population of outpatients with heroin addiction enrolled at methadone maintenance treatment program in four hospitals in northern Taiwan. We adopted costs and effectiveness from patients’ perspective. The WHOQOL-BREF and the employment status were administered at baseline and at one-year follow-up to calculate the incremental quality of life (QoL) gained and the wages differences. The averted incarceration costs were computed by the estimates from government reports or literatures and the criminal records from Ministry of Justice.

Results: The implementation of MMT program cost were 37,989, 38,992 and 40,195 NT dollars from 2009 to 2011; however, without the implementation of MMT program, the cost was 672,954. The measurements for benefit were quality of life, employment, and criminal activities. The cost per QoL (Quality of Life) in physical health domain was the highest of four domains (24,214 NT dollars) and the cost per QoL in psychological health domain was the lowest (10,280 NT dollars). The unemployment rate decreased after one-year follow-up; however, the wages per hour slightly decreased. Compared with the year of 2004 to 2007, the intervention of MMT decreased criminal offenses and incarceration costs.

Conclusions: During one-year follow-up of MMT, this study has shown that methadone maintenance treatment is cost-effective in terms of quality of life improvement, increased employment and averted incarceration costs.

關鍵字

cost ； effectiveness ； employment ； methadone ； quality of life

並列摘要

Objective: This paper examined the costs and the effectiveness before the Methadone Maintenance Treatment (MMT) and after one-year follow-up of MMT from patients’ perspective in four hospitals in northern Taiwan.

Methods: The participants in this study were recruited from the population of outpatients with heroin addiction enrolled at methadone maintenance treatment program in four hospitals in northern Taiwan. We adopted costs and effectiveness from patients’ perspective. The WHOQOL-BREF and the employment status were administered at baseline and at one-year follow-up to calculate the incremental quality of life (QoL) gained and the wages differences. The averted incarceration costs were computed by the estimates from government reports or literatures and the criminal records from Ministry of Justice.

Results: The implementation of MMT program cost were 37,989, 38,992 and 40,195 NT dollars from 2009 to 2011; however, without the implementation of MMT program, the cost was 672,954. The measurements for benefit were quality of life, employment, and criminal activities. The cost per QoL (Quality of Life) in physical health domain was the highest of four domains (24,214 NT dollars) and the cost per QoL in psychological health domain was the lowest (10,280 NT dollars). The unemployment rate decreased after one-year follow-up; however, the wages per hour slightly decreased. Compared with the year of 2004 to 2007, the intervention of MMT decreased criminal offenses and incarceration costs.

Conclusions: During one-year follow-up of MMT, this study has shown that methadone maintenance treatment is cost-effective in terms of quality of life improvement, increased employment and averted incarceration costs.

並列關鍵字

cost ； effectiveness ； employment ； methadone ； quality of life

參考文獻

Allen, C. (2005). The links between heroin, crack cocaine and crime - Where does street crime fit in? British Journal of Criminology, 45(3), 355-372

APA. (1994). American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition (DSM-IV)). Washington, DC.

Barnett, P. G. (1999). The cost-effectiveness of methadone maintenance as a health care intervention. Addiction, 94(4), 479-488.

Basu, A., Paltiel, A. D., & Pollack, H. A. (2008). Social costs of robbery and the cost-effectiveness of substance abuse treatment. Health Economics, 17(8), 927-946.

CE Inturrisi, K. V. (1973). The levels of methadone in the plasma in methadone maintenance. Clinical Pharmacology and Therapeutics, 13(5), 633-637.