慢性心力衰竭患者专人定期随诊的远期疗效性价比  

The Effect of Specialized Follow-Up on the Long-Term Treatment Cost-Effective Ratio in Patients with CHF

作　　者：陆致玲[1] 陈哲[1] 刘淼冰[1] 张丽[1] 弓梅芳[1] 楚研研[1] 张麟[1] 

机构地区：[1]首都医科大学附属北京朝阳医院干部/普内科,北京100020

出　　处：《中国医药导刊》2007年第3期184-185,188,共3页Chinese Journal of Medicinal Guide

摘　　要：目的:比较三年专人定期随诊对慢性心力衰竭(CHF)患者的远期疗效和经济效价比,探讨心力衰竭(HF)患者就医行为和临床预后的相关性。方法:选择1998年11月1日～2000年12月31日临床确诊并符合CHF诊断标准的住院和门诊患者310例,其中男219例,女91例。将三年中能坚持并接受定期专人随诊的患者划为规范组,未定期非专人随诊患者划为非规范组。分别比较两组三年死亡率、再住院率和医疗费用。结果:(1)310例患者三年累计失访率高达41．3% (128/310),规范组患者仅69例,非规范组患者113例,分别占全部观察病例的22．3%和36．5%。(2)规范组患者的心功能、左室舒张末经、收缩末经及左室射血分数均明显好于非规范组。(3)规范组患者的三年累计死亡率、再住院率和医疗费用分别为11．6%、8．7%和10361元,明显低于非规范组的41．6%、25．7%和34804元。结论:长期接受专人定期随诊的HF患者三年累计死亡率、再住院率和医疗费用均明显低于非定期非专人随诊的HF患者。规范CHF患者的就医行为,加强定期专人HF患者的随诊是改善患者临床预后最重要的措施之一。Objective： To understand and compare the clinical effect and cost - effective ratio in patients with chronic heart failure （CHF）, who received specialized treat.Methods： There were 310 patients with CHF in the study, including 219 males and 91 females. All patients were told that they should accept specialized follow - up among the three years. They were divided into the standardized group and the non - standardized group by patients whether or not accepting specialized treat and follow - up. Results： （1） Among the 310 patients, 128 patients （41.3%） were missing （not any their information）, only 69 patients （22.3%） in the standardized treatment group and 113 patients （36.5 % ） in the non - standardized group. （2） There were significant improvement in standardization group compared with in non - standardization group of the heart function class, left ventricular end - diastolic diameter, left ventricular end - systolic diameter and left ventricular ejection fraction. （3） The rate of re - hospitalization, mortality and the expenditure on medical care in standardization group were better than that in non - standardization group （ 11.6%, 8.7% and 10361 RMB VS. 41.6%, 25.7% and 34804RMB respectively）. Conclusion：The rate of re - hospitalization, mortality and the expenditure on medical care were decreased significantly in the standardized group than that in non - standardized group. The prognoses of patients with CHD were greatly improved by supervising medical behavior and intensifying the specialized treatment and follow - up by schedule.

关 键 词：慢性心力衰竭 死亡率 再住院率 医疗费用 

分 类 号：R541.6[医药卫生—心血管疾病]