卒中小组模式的卫生经济学评价  

Economic health evaluation for stroke team mode

作　　者：薛嘉[1] 徐嘉玲[1] 郭庆荣[1] 白良[1] 杨成蓉[1] 龙毅[1] 

机构地区：[1]雅安市人民医院神经内科,四川省雅安市625000

出　　处：《中国临床康复》2004年第34期7622-7624,共3页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:研究卒中小组模式在脑梗死患者住院期间的卫生经济学评价,探索适合中国国情的卒中单元模式。方法:2003-01/2004-03雅安市人民医院神经内科收治的急性脑梗死患者150例,随机进入卒中小组和普通病房。观察指标是病死率、住院时间、神经功能缺损程度评分,简式Fugl-Meyer运动功能评分(FMA),改良Barthel指数(MBI)。经SPSS统计,用费用效益分析对卒中小组进行卫生经济学评价。结果:卒中小组病死率低于普通病房(P<0.05),且康复效果明显(P<0.01)。卒中小组与普通病房比较神经功能缺损评分每减少1分、FMA评分每增加1分、MBI每提高1分需分别减少花费(人民币)736.59,317.48,410.05元。两组患者住院时间和医疗费用差异无显著性意义(P>0.05)。结论:相比普通病房,卒中小组病房能减少脑梗死住院患者的病死率,明显提高患者的早期日常生活能力,减少神经功能缺损,提高回归社会的能力,不增加患者的花费。卒中小组在脑卒中早期康复中更为经济。AIM: To investigate the economic health evaluation of stroke team on cerebral infarction patients in hospital, and explore the mode of stroke unit suiting for Chinese situation. METHODS: Totally 150 cases of acute cerebral infarction were admitted into the Department of Neurology, the People's Hospital of Yaan from January 2003 to March 2004.All patients were assigned into stroke team or general ward randomly to receive treatment, and the data of the patients of the two groups were compared. The key indexes recorded were mortality and hospitalization time and other parameters observed were clinical neurological defects, simple Fugl Meyer Assessment(FMA),modified Barthel index(MBI). All these data, incorporated with cost effectiveness, were analyzed with SPSS software. RESULTS: The mortality rate was less(P< 0.05) and rehabilitation efficacy was more obvious(P< 0.01) in stroke team than in general ward. The cost were less in stroke team than in general ward when the clinical neurological defects scores were reduced 1 point, FMA and MBI scores improved 1 point, and the cost reduced 736.59, 317.48, 410.05 yuan RMB. But the hospitalization time and medical costs had no significant difference between the two groups(P >0.05). CONCLUSION:For cerebral infarction patients, stroke team is able to decrease the mortality rate, improve the activities in early stage, reduce neurological defects and restore social abilities with fewer expenses. The cost effectiveness analysis shows that the stroke team is more economic.

关 键 词：卒中小组 卫生经济学 康复 急性脑梗死 普通病房 神经功能缺损 

分 类 号：R743.3[医药卫生—神经病学与精神病学]