中国癫患儿门诊诊疗相关成本初步分析  

Preliminary Study on Treatment-Related Cost for Childhood Epilepsy in Out-patient Clinic in China

作　　者：相婷[1] 吴晔[1] 桑田[1] 朱赛楠[2] 臧莉莉[1] 高静云[3] 赵海娟[1,4] 黄琼辉[1] 王颖慧[1] 王丽[1] 姜玉武[1] 

机构地区：[1]北京大学第一医院儿科,北京100034 [2]北京大学第一医院医学统计室,北京100034 [3]唐山市妇幼保健院儿科,河北唐山063000 [4]山西医科大学附属第一医院神经内科,太原030001

出　　处：《实用儿科临床杂志》2011年第21期1656-1660,共5页Journal of Applied Clinical Pediatrics

基　　金：首都医学发展基金(2009-2021);教育部新世纪人才支持计划

摘　　要：目的了解目前北京大型三级甲等医院小儿癫中心就诊的癫患者治疗相关成本情况,以期为医疗卫生政策的制订以及有限医疗资源的合理配置提供重要依据。方法研究对象为2010年4月-2011年1月于北京大学第一医院小儿神经科门诊就诊的癫患者,所有癫患者治疗至少1 a以上。填写调查问卷,内容包括:患者基本信息、疾病相关信息、治疗相关信息及治疗相关成本。问卷内容所涉及的癫发作频率和治疗相关成本等针对1 a以来的情况进行回顾性调查。在治疗成本的相关因素分析中,分别对因变量[直接成本、抗癫药物(AEDs)费用、交通费和检查费]进行相关因素分析(自变量包括:年龄、体质量、地区、1 a以来有无癫发作、病程、AEDs种数、是否使用新型AEDs)。结果 209例患者1 a的治疗相关的总成本中位数为7 336元(660～88 808元),其中直接成本中位数为6 680元(400～86 728元),间接成本中位数364元(0～3 640元)。总成本构成比(以中位数表示):直接成本占94.59%(50.85%～100.00%),间接成本占5.41%(0～49.15%)。直接成本的构成中AEDs费用、检查费和交通费是主要组成部分。1 a以来有无发作、是否服用新型AEDs、居住地区、年龄、病程从不同方面对于直接成本产生影响。结论本研究是针对国内癫患者治疗成本的首次较大样本的研究。从一个侧面反映出我国癫患者的治疗成本非常昂贵,占人均国民生产总值的28.68%。政府部门亟待制定政策,降低患者家庭的治疗成本。Objective To understand the current status of treatment and the related costs of children in a major pediatric epilepsy center,and to analysis related factors. It was hoped that the study can provide basis for health policy improvement. Methods Cases were collected in out - patient clinics Department of Pediatrics in Peking University First Hospital from Apr. 2010 to Jan. 2011 ,with duration of antiepileptic therapy for at least 1 year. Questionnaires were filled by the parents. The content of the questionnaire was as follows ： the basic informa- tion of the children, disease - related information, treatment - related information, treatment - related costs. The seizure frequency and treatment - related costs involved in the questionnaire were retrospective survey for the past year. Then appropriate statistical methods were used to describe and analyse basic demographic characteristics, disease, treatment costs, cost structure ratio, and related factors. Results The median of direct cost was 6 680 yuan （400 - 86 728 yuan） ,indirect cost was 364 yuan （0 - 3 640 yuan）, and total cost was 7 336 yuan （660 - 88 808 yuan）. The constituent ratio of the total cost varied among the 209 cases, with the median of direct cost 94.59% （50.85% - 100.00% ） , and indirect cost 5.41% （0 -49.15 % ）. The cost of anti - epileptic drugs （AEDs） , inspection fees and travel expenses were the major components of the direct costs. With or without seizures,with or without new AEDs, age, geographical distribution, and disease courses were related factors. Conclusions This is the first study on the cost for childhood epilepsy with relatively large sample size in China. The treatment of children with epilepsy causes a heavy burden on family and society, which accounted for 28.68% of gross national product per capita. There is an urgent need to develop policies to reduce the burden for patients＇ family.

关 键 词：癫 治疗相关成本 儿童 中国 

分 类 号：R742.1[医药卫生—神经病学与精神病学]