小儿脑性瘫痪康复模式的效果-成本分析  

The cost-effectiveness of various rehabilitation patterns for children with cerebral palsy

作　　者：吴建贤[1] 黄金华[2] 童光磊[3] 张敏[3] 李红[3] 徐梅[1] 赵敬璞[1] 汪国宏[2] 

机构地区：[1]安徽医科大学第二附属医院康复医学科,合肥230601 [2]安徽省合肥市第一人民医院儿科 [3]安徽省省立儿童医院小儿神经康复科

出　　处：《中华物理医学与康复杂志》2009年第1期47-50,共4页Chinese Journal of Physical Medicine and Rehabilitation

摘　　要：目的 分析不同康复模式对小儿脑性瘫痪产生的经济学效果.方法 将153例脑瘫患儿分为医院-社区-家庭康复组(n=52)、医院内康复组(n=50)和无干预措施组(n=51),分别施行医院-社区-家庭康复模式、医院内康复模式和无干预措施治疗.3组均于入组时、第3和第6个月采用粗大运动功能-88评估表(GMFM-88)、费用统计表进行评估.结果 入组时,3组患儿粗大运动功能各项经统计学分析,差异无统计学意义(P>0.05);第3和第6个月,医院-社区-家庭康复组与医院内康复组患儿和无干预措施组比较,其粗大运动功能的总百分比、月百分比和月相对百分比差异均有统计学意义(P<0.01);但无干预措施组内差异无统计学意义.第3和第6个月后医院-社区-家庭康复组粗大运动功能评分每提高1分的费用分别为(101.87±97.59)元,(75.11±45.75)元,而医院内康复组为(387.21±54.76)元,(170.31±123.16)元,前者比后者低2～3倍,两组间差异有统计学意义(P<0.01).结论 医院内康复适用于肺瘫患者的早期康复,而医院-社区-家庭康复适用于脑瘫患儿的长期康复,且可减少患儿康复费用的支出,是比较适合我国国情的一种脑瘫康复模式.Objective To analyze the economic effects of different rehabilitation patterns for children suffering from cerebral palsy. Methods A total of 153 cerebral palsy patients were divided into a hospital-community-family rehabilitation group(n = 52), a hospital rehabilitation group (n = 50) and a non-intervention control group (n = 51). Those in the first group were provided with a hospital-community-family rehabilitation therapy pattern, those in the sec-ond only hospital rehabilitation and the third no intervention. All the patients were evaluated using the Gross Motor Function Measure-88 (GMFM-88) Scale and the Cost Measure Scale at admission, and at the end of the 3rd and 6th months of treatment. Results There were no significant differences in gross motor function among the three groups at admission. At the end of the 3rd month and the 6th month there were significant differences between the children in the hospital-community-family rehabilitation program and those in the hospital rehabilitation program in terms of gross motor function. Their general percentage, monthly percentage and monthly relative percentage results were all significantly different. But there was no significant difference in the non-interventian control group since admission. Every unit of improvement in gross motor function cost $101.87±97.59, $75.11±45.75 in the hospital-community-family reha-bilitation program and $387.21±54.76, $170.31±123.16 in the hospital rehabilitation program at the end of the 3rd and the 6th month respectively. So the cost of the former was only about 30% of the latter. Conclusion Hospital rehabilitation is suitable for the early rehabilitation of cerebral palsy children. Hospital-community-family rehabilitation is better for long-term rehabilitation of cerebral palsy children, and what is more, it can decrease the rehabilitation ther-apy cost substantially. So a hospital-community-family rehabilitation pattern is more compatible with China's national situation.

关 键 词：医院-社区-家庭康笈 脑瘫 粗大运动功熊 效果-成本分析 

分 类 号：R742[医药卫生—神经病学与精神病学]