Abstract Objective: The recognition of concurrent disorders (combined mental health and substance use disorders) has increased substantially over the last three decades, leading to greater numbers of people with these diagnoses and a subsequent greater financial burden on the health care system, yet establishing effective modes of management remains a challenge. Further, there is little evidence on which to base recommendations for a particular mode of health service delivery. This paper will further summarize the existing treatment models for a comprehensive overview. The objectives of this study are to determine whether existing service models are effective in treating combined mental health and substance use disorders and to examine whether an integrated model of service delivery should be recommended to policy makers. The following two research questions are the focus of this paper: (1) Are the existing service models effective at treating mental health and substance use disorders? (2) How are existing service models effective at treating mental health and substance use disorders? Methods: We used various databases to systematically review the effectiveness of service delivery models to treat concurrent disorders. Models were considered effective if they are found to be cost-effective and significantly improve clinical and social outcomes. Results: This systematic review revealed that integrated models of care are more effective than conventional, nonintegrated models. Integrated models demonstrated superiority to standard care models through reductions in substance use disorders and improvement of mental health in patients who had diagnoses of concurrent disorders. Our meta-analysis revealed similar findings, indicating that the integrated model is more cost-effective than standard care. Conclusions: Given the limited number of studies in relation to service delivery for concurrent disorders, it is too early to make a strong evidence-based recommendation to policy makers and service providers as to the superiority of one approach over the others. However, the available evidence suggests that integrated care models for concurrent disorders are the most effective models for patient care. More research is needed, especially around the translation of research findings to policy development and, vice versa, around the translation from the policy level to the patients’ level.

中文翻译：

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并发疾病综合护理综述：成本效益和临床结果

摘要 目的：在过去的 30 年中，对并发障碍（精神健康和物质使用障碍的组合）的认识显着增加，导致更多的人患有这些疾病，随后对医疗保健系统造成更大的经济负担，但建立了有效的管理模式仍然是一个挑战。此外，几乎没有证据可以为特定的卫生服务提供模式提供建议。本文将进一步总结现有的治疗模型，以进行全面概述。本研究的目的是确定现有的服务模式是否能有效治疗精神健康和物质使用障碍，并检查是否应向决策者推荐综合服务提供模式。以下两个研究问题是本文的重点：（1）现有的服务模式在治疗心理健康和物质使用障碍方面是否有效？(2) 现有的服务模式如何有效治疗精神健康和物质使用障碍？方法：我们使用各种数据库来系统地审查服务提供模型治疗并发疾病的有效性。如果发现模型具有成本效益并显着改善临床和社会结果，则认为模型是有效的。结果：这项系统评价表明，综合护理模式比传统的非综合模式更有效。综合模型通过减少物质使用障碍和改善被诊断患有并发障碍的患者的心理健康证明优于标准护理模式。我们的荟萃分析揭示了类似的发现，表明集成模式比标准护理更具成本效益。结论：鉴于与并发障碍服务提供相关的研究数量有限，现在就一种方法优于其他方法的优势向政策制定者和服务提供者提出强有力的循证建议还为时过早。然而，现有证据表明，针对并发疾病的综合护理模式是最有效的患者护理模式。需要更多的研究，尤其是将研究结果转化为政策制定，反之亦然，