哈尔滨市农村癫痫患者卫生经济学评价研究  

Evaluation of health economics for rural epilepsy patients in Harbin

作　　者：高菡璐 兰莉[2] 樊金卿[3] 杨超 林琳[2] 张婷婷[2] 何伟丽[4] 张亚旭[4] GAO Han-lu;LAN Li;FAN Jin-qing;YANG Chao;LIN Lin;ZHANG Ting-ting;HE Wei-li;ZHANG Ya-xu(Department of Preventive Health,Affiliated Hospital of Medical School of Ningbo University,Ningbo,Zhejiang 315000,China;不详)

机构地区：[1]宁波大学医学院附属医院防保科,浙江宁波315000 [2]哈尔滨市疾病预防控制中心慢病所,黑龙江哈尔滨150056 [3]宁波大学医学院附属医院皮肤科,浙江宁波315000 [4]黑龙江省疾病预防控制中心慢病所,黑龙江哈尔滨150026

出　　处：《现代预防医学》2020年第16期2986-2989,共4页Modern Preventive Medicine

基　　金：黑龙江省卫生健康生育委员会科研课题(2019-241、2019-174)。

摘　　要：目的通过对农村癫痫患者的卫生经济学评估,确定癫痫患者管理模式的投入与产出,优化卫生资源配置,为卫生政策的制定提供理论依据。方法将236例参与农村癫痫防治管理项目初筛,被诊断为惊厥型癫痫患者分为2组,其中项目组149例,对照组87例。项目组采用单纯苯巴比妥药物治疗,对照组为已确诊但未加入项目组治疗的患者。随访6个月,以有效率和QALYs作为效果和效用的评价指标,对癫痫患者的成本-效果和成本-效用进行卫生经济学评价。结果项目组和对照组在治疗效果上具有统计学差异(χ^2=20.71,P<0.05),项目组有效治疗1例癫痫患者所花费的成本为57.82元,而对照组的成本为116.89元,为项目组的2.04倍;获得每1个分值生命质量,项目组需花费1 080.34元,而对照组则需花费1 806.09元。相对于对照组,项目组每增加1个QALY的增量成本为-10386.43元。结论使用苯巴比妥药物治疗惊厥型癫痫患者疗效具有优势,且成本-效用优势明显,适合在农村地区广泛推广和应用。Objective The aim of this study was to determine the input and output of the management mode of epilepsy patients,optimize the allocation of health resources,and provide theoretical basis for the formulation of health policies through evaluation of health economics for rural epilepsy patients.Methods 236 patients with epilepsy diagnosed as convulsive epilepsy were initially screened from rural epilepsy prevention and management project and divided into two groups,with 149 cases in the project group and 87 cases in the control group.The project group was treated with phenobarbital alone and the control group included patients who were diagnosed but not treated by the program.Each group was followed up for 6 months.Efficiency and QALYs were calculated as the evaluation indexes of effectiveness and utility and health economics were conducted to evaluate the cost-effectiveness and cost-utility of epilepsy patients,respectively.Results There was a statistical difference between the project group and the control group in the treatment effect(χ^2=20.71,P<0.05).The project group spent 57.82 yuan to effectively treat one epileptic patient,while the control group spent 116.89 yuan,which was 2.04 times of the project group.For each life quality score,the project team spent 1080.34 yuan,while the control group spent 1806.09 yuan.Compared with the control group,the incremental cost of each additional QALY in the project team was-10386.43 yuan.Conclusion Using phenobarbital in the treatment of convulsive epilepsy patients had obvious advantages in curative effect and cost advantage.It is suitable for extensive promotion and application in rural areas.

关 键 词：癫痫 成本效果 成本效用 QALYS 效用值积分体系 

分 类 号：R741[医药卫生—神经病学与精神病学]