中国13个城市经皮冠状动脉介入治疗的成本疗效分析  

Cost-utility analysis of percutaneous coronary intervention in 13 cities of China

作　　者：宋现涛[1] 杜梦阳[1] 苑飞[1] 吕树铮[1] 无 

机构地区：[1]首都医科大学附属北京安贞医院心内科,100029 [2]代表冠心病介入治疗现状及医疗保险基金支付办法研究协作组

出　　处：《中华心血管病杂志》2010年第6期484-487,共4页Chinese Journal of Cardiology

摘　　要：目的 对经皮冠状动脉介入治疗（PCI）进行成本疗效分析.方法 连续收集2006年1月至6月在中国13个城市行PCI的冠心病患者资料.利用SF-36健康调查量表对患者住院期间及出院9个月后的生命质量进行问卷调查,并依此进行成本疗效分析.结果 （1）51.8%接受PCI的冠心病患者年龄在60岁以下.（2）患者住院成本中材料成本占82.5%、西药费占6.8%、手术费占5.9%,这3项共占总住院成本的95.2%,其中支架费用占材料成本的69.8%.（3）术后1年内患者再次入院成本：44例由于发生不良反应事件而再次入院患者的平均再次住院成本为17 841.5元.（4）术后1年内的药物费用：以使用频率最高的5种药（阿司匹林、氯吡格雷、美托洛尔、阿托伐他汀和辛伐他汀）的使用量和价格为依据,通过对患者术后1、3、6、9、12个月的随访调查显示,患者在术后平均每个月的药费为831.5元,每个月药费为400.0元的患者最多.（5）患者治疗后的生命质量显著提高,平均得分提高20.59分;每提高一个分值的生命质量需花费3975.7元;每获得一个质量调整生命年花费59 898.3元.结论 我国PCI的成本疗效比在一个较为理想的范围内.Objective To investigate the cost-utility of percutaneous coronary intervention（PCI）in China.Mcthods A total of 630 patients from 13 cities undergoing PCI during the first half year of 2006 were enrolled in this study.The 36 items derived from the short form of health survey（SF-36）were applied prospectively in these patients before and 9 months after PCI.The cost per every incremental mark of SF-36 and quality adjusted life year（QALY）were calculated.Results（1）The age was lower than 60 years old in more than 50%patients.（2）In terms of detailed costs,material costs accounted for 82.5%of the hospitalization costs.medications costs accounted for 6.8%,and operation fee accounted for 5.9%.These 3 iterns comprised 95.2% of overall hospitalization costs,and 69.8% material costs were the cost for stents.（3）The average re-admission hospitalization costs were 17 841.5 RMB in 44 patients who were rehospitalized due to occurrence of major adverse cardiac events.（4）Follow-up made at months 1,3,6,9,and 12 post index procedure showed that an average cost for postoperative drug treatment was 831.50RMB per month,and most patients spent 400.0 RMB for drug treatment per month.（5）The average quality of life score increased by 20.59 post PCI（P〈0.05 vs.pre-PCI）.The cost-effective analysis indicates that the cost per every incremental mark of SF-36 was 3975.7 RMB.The cost per every QALY gained was 59 898.3 RMB.Conclusion PCI is effective for patients with coronary heart disease and the cost per QALY in China was positioned in an acceptable range.

关 键 词：血管成形术 经腔 经皮冠状动脉 费用效益分析 质量校正寿命 

分 类 号：R541.4[医药卫生—心血管疾病]