医院与社区综合干预模式治疗老年高血压患者的药物经济学分析  

Pharmacoeconomic analysis of hospital and community integrated intervention model in elderly patients with hypertension

作　　者：朱磊[1] 刘敏[1] 于洋[1] 杨明[1] 程波[1] 吴虹[1] 艾丽[1] 刘晓玲[1] 张苏川[1] ZHU Lei;LIU Min;YU Yang;YANG Ming;CHENG Bo;WU Hong;AI Li;LIU Xiao-ling;ZHANG Su- chuan(Affiliated Hospital of Jianghan University, Hubei Wuhan 430015, China)

机构地区：[1]江汉大学附属医院,湖北武汉430015

出　　处：《中国医院药学杂志》2018年第12期1320-1324,共5页Chinese Journal of Hospital Pharmacy

基　　金：武汉市卫计委科研基金(编号:WG15D21)

摘　　要：目的:对医院与社区综合干预模式治疗老年高血压患者进行药物经济学分析,以探讨综合干预模式对患者治疗费用的影响。方法:以某社区老年高血压病患者为研究对象,随机分为对照组与观察组各120例。对照组仅由医院医师制定及调整治疗方案并进行诊疗干预,而观察组在对照组基础上联合社区医师进行诊疗干预。2组患者均随访12个月,在干预前、随访6个月及随访12个月时采用欧洲五维健康量表评价患者的生存质量,计算患者质量调整生命年(QALYs)并作为效用指标;所有患者研究期间干预措施产生的费用作为成本指标,采用成本-效用分析方法对综合干预模式进行药物经济学分析。结果:与观察组相比,对照组直接成本及间接成本均明显高于观察组,差异均具有显著性(P<0.05);与干预前比较,随访6个月及12个月时,2组效用值及VAS评分均明显升高,观察组效用值及VAS评分明显高于对照组,差异均具有显著性(P<0.05);对照组与观察组成本效用比值分别为10 887.27及9 014.41、QALYs分别为75.62及84.16,与对照组相比,观察组每增加1个QALYs的同时少花费7 569.46元。结论:医院与社区综合干预是一种经济、有效的老年高血压管理模式,改善患者的生活质量的同时也可降低患者的治疗成本,值得临床推广使用。OBJECTIVE To analyze the effect of comprehensive intervention mode on the treatment cost of elderly patients with hypertension by the comprehensive intervention mode of hospital and community.METHODS A community of elderly hypertensive patients was randomly divided into the control group and the observation group,each with 120 cases.In the control group,only the doctors in our hospital made and adjusted the treatment plan and the treatment intervention,while patients in the observation group were treated by community doctors on the basis of the control group.Two groups were followed up for 12 months,the European five dimensional health assessment was used to assess the quality of life of patients before intervention,6 months follow-up and 12 months follow-up,to calculate the quality adjusted life years（QALYs）as a utility index.All expense of interventions in patients during the study period were used as the cost index,using the cost utility analysis method of pharmaco-economics analysis as the comprehensive intervention model.RESULTS Compared with the observation group,the control group had obviously higher direct and indirect costs than those of the observation group（P〈0.05）.Compared with that before intervention,at follow-up of 6 months and 12 months,two groups had significantly increased utility values and VAS scores（P〈0.05）.In the control group and the observation group,the utility ratios were 10 887.27 and 9 014.41,QALYs were 75.62 and 84.16.Compared with the control group,the observation group had 1 QALYs more and 7 569.46 yuan less.CONCLUSIONThe hospital and community comprehensive intervention is an economical and effective management mode for elderly hypertension.It can improve the quality of life of patients and reduce the cost of treatment,and is worthy of clinical promotion.

关 键 词：综合干预 老年高血压 经济学分析 

分 类 号：R972.4[医药卫生—药品]