急性脑卒中康复治疗的成本-效果分析  

Cost-effectiveness analysis of rehabilitation treatment in patients with acute cerebrovascular disease

作　　者：张继荣[1] 吴霜[1] 黄宇[1] 冯丽丽[1] 陈庭凤[1] 龙燕[1] 李玫[1] 李玲[1] 马丽[1] 王连芳[1] 冯晓敏[1] 

机构地区：[1]贵阳医学院附属医院康复医学科,贵阳550004

出　　处：《中华物理医学与康复杂志》2005年第12期749-751,共3页Chinese Journal of Physical Medicine and Rehabilitation

基　　金：国家"十五"攻关项目资助课题(No.2001BA703B21)

摘　　要：目的探讨急性脑卒中三级康复方案的经济有效性。方法将2002年1月1日至2003年12月31日住院的符合入选条件的急性脑卒中患者80例,随机分为康复组和对照组,康复组给予规范的三级康复治疗,对照组不进行任何康复治疗,但不排除自行的传统康复(如针灸、推拿等),2组均采用常规的内科治疗;在入选时及发病后1,3,6个月末用简化Fugl-Meyer运动功能评定法(FMA)、改良Barthel指数评定法(MBI)、综合功能评定法(FCA)分别进行评定,并计算三级康复治疗的总成本,包括直接医疗成本、间接医疗成本、间接成本,进行成本-效果分析。结果入选时康复组与对照组各项测评量表的差异无统计学意义(P>0.05);康复组经过规范的三级康复治疗后,各项测评量表的评分明显高于对照组,差异有统计学意义(P<0.01),各项测评量表评分的增加值也明显高于对照组(P<0.01)。康复组患者的总费用(人民币元)为(32228.11±2723.24)元,对照组为(33593.57±6584.97)元,2组差异无统计学意义(P>0.05),但康复组各项测评量表每增加一分所需费用比对照组少,2组差异有统计学意义(P<0.05)。康复组与对照组比较,运动功能评分每增加1分,少花费33.8元;日常生活能力评分每提高5分,少花费243.19;综合功能评分每增加1分,少花费64.03元。结论急性脑卒中三级康复方案是一种既经济又有显著疗效的康复治疗方案。Objective To explore whether the 3-stage rehabilitation intervention approach is an economic and effective way of treatment for the patients with cerebrovascular diseases. Methods Eighty cases with acute cerebrovascular diseases （58 male and 22 female;average age 62.94 ± 8.59; 40 cases of brain infarction and 40 cases of brain hemorrhage; 2 died） have been divided randomly intoa treatment group and a control group. The treatment group was treated with the 3-stage rehabilitation intervention approach whereas the control group was given no formal rehabilitation treatment except for possible patients＇self administration of acupuncture or massage. Both groups received routine treatment of internal medicine. Both groups were evaluated with simplified Fugl-Myer scale, simplified ADL scale and comprehensive functional scale at the beginning and the end of the treatment. The total cost including the direct and indirect medical costs, and other indirect cost were calculated and analyzed. Results There was no significant difference between the two groups at admission, in terms of their functional status as reflected by evaluation using the various scales （ P 〉 0.05）. After treatment, the scores with all the evaluation scales of the treatment group were significantly higher than those of the control group （P 〈 0. 001 ） , and the increasing rate of the scores were also significant higher in the treatment group. The total costs of the rehabilitation group and the control group were 32 228.11 ± 2 723.24 and 33 593.57 ± 6 584.97 yuan RMB, respectively, which showed no significant difference （ P 〉 0.05 ）. The money spent for every one-point score of increase of rehabilitation group was significantly lower than that of the control group （P 〈 0.05）. The rehabilitation group spent 33.8 yuan RMB less in increasing every functional point, 243.19 yuan RMB less in increasing every 5 ADL points and 64.03 yuan RMB less in increasing every comprehensive functional point than those of the control group. Con

关 键 词：脑卒中 康复 效果 成本 

分 类 号：R743.3[医药卫生—神经病学与精神病学] F407.7[医药卫生—临床医学]