196. The effect and COST-effectiveness of community nursing models on mental health care for patients with depression under economic pressure

Abstract Background The rising economic pressure on residents caused by global economic fluctuations has become an important trigger for the onset and deterioration of depression. Meanwhile, the traditional centralized hospital care model is difficult to meet the long-term care needs of depression patients under economic pressure. Most existing studies focus on the improvement effect of a single medical intervention on the symptoms of depression, and rarely combine the community care model with the background of economic pressure. Therefore, the study aims to verify the effectiveness of the community care model in improving the mental health level of patients with depression related to economic stress, and to evaluate its cost–benefit advantages from the dimensions of cost input and health output. Methods The study adopted a randomized controlled trial design. A total of 240 patients diagnosed with depression in a certain area from January 2023 to January 2024, who met the diagnostic criteria and had significant economic pressure, were randomly divided into an intervention group and a control group in a 1:1 ratio, with 120 cases in each group. The control group adopted the conventional hospital outpatient nursing model, while the intervention group implemented the community nursing model. The intervention period for both groups of patients was 6 months. During the research process, the Hamilton Depression Rating Scale was adopted. The mental Health status was evaluated by HAMD-17 and the Patient Health Questionnaire-9 Depression Scale (PHQ-9). Results After 6 months of intervention, the score of the HAMD-17 scale in the intervention group decreased from 26.3 ± 4.1 points before the intervention to 8.7 ± 2.5 points, and the score of the PHQ-9 scale decreased from 18.5 ± 3.2 points before the intervention to 5.2 ± 1.8 points. The score of the HAMD-17 scale in the control group decreased from 25.9 ± 3.8 points to 15.3 ± 3.0 points, and the score of the PHQ-9 scale decreased from 18.1 ± 3.0 points to 10.6 ± 2.2 points. The difference in the decrease of scale scores between the two groups was statistically significant (p<.001). The cost-effectiveness ratio calculation results show that for every 1-point reduction in the scale score of the intervention group, the required cost is 40.6 yuan, while that of the control group is 126.3 yuan. The cost benefit advantage of the intervention group is significant (p<.001). Discussion The research results confirm that the community care model under the background of economic pressure can significantly improve the mental health symptoms of patients with depression, enhance treatment compliance, and effectively reduce the total medical cost, demonstrating a prominent cost–benefit advantage. This model, by decentralizing medical resources to communities, resolves the medical treatment obstacles faced by economically pressured patients due to issues such as transportation and costs, and enhances the accessibility of nursing services. However, the extrapolation of the research results needs further verification, and the long-term effects of the community care model have not been tracked. Future research can include patients from regions with different levels of economic development and conduct multi-center long-term follow-up studies.