脊髓损伤工伤人员不同时期康复介入的治疗效果和经济学评价  

Effect and economic evaluation of rehabilitation interventional therapy at different stages in work-related injured personnel with spinal cord injury

作　　者：冯烨 郭进 冒海建 朱逸溪 舒甜 王燕 翟华 FENG Ye;GUO Jing;MAO Haijian;ZHU Yixi;SHU Tian;WANG Yan;ZHAI Hua(Shanghai Municipal Yangzhi Rehabilitation Hospital/Shanghai Municipal Sunshine Rehabilitation Center,Shanghai 201619,China)

机构地区：[1]上海市养志康复医院/上海市阳光康复中心工伤康复管理办公室,上海201619

出　　处：《现代医药卫生》2020年第17期2667-2670,共4页Journal of Modern Medicine & Health

基　　金：上海市残疾人联合会残疾人康复科研鼓励项目(39);上海市松江区科学技术委员会科技攻关项目(19SJKJGG95)。

摘　　要：目的对脊髓损伤(SCI)工伤人员在不同时期介入康复治疗的效果和费用-效果的经济学评价。方法选取2017年7月至2019年1月在该院住院康复的SCI工伤人员115例,按相关操作流程分为快速通道组(59例)和常规申请组(56例)。采用日常生活能力评定量表(MBI)、抑郁自评量表(SDS)评定其入院后和出院前功能和心理状况。通过问卷调查和调用住院账单的方式收集其直接医疗费用、直接非医疗费用和间接费用。采用直接医疗费用与MBI和SDS改善量的比数推断费用-效果比。结果快速通道组工伤人员MBI评分、SDS评分、具备返岗能力比例均明显高于常规申请组,差异均有统计学意义(t=6.818、-2.333,χ^2=8.126,P<0.001、0.023、0.004);MBI每增加1分、SDS每减少1分所需费用均明显低于常规申请组,差异均有统计学意义(t=-5.419、2.644,P<0.001、0.010)。结论实行工伤康复快速通道是一种经济、有效的模式。Objective To conduct the effect and economic evaluation of interventional rehabilitation therapy at different stages in the work-related injured personnel with spinal cord injury(SCI).Methods A total of 115 work-related injured personnel with SCI hospitalized in this hospital from July 2017 to January 2019 were selected and divided into the rapid track group(59 cases)and conventional application group(56 cases)according to the relevant operation procedure.The functional and psychological status of SCI personnel after admission and before discharge were assessed by adopting the Modified Barthel Index(MBI)and Self-rating Depression Scale(SDS).Meanwhile,the direct medical,direct non-medical and indirect expenses were collected by the questionnaire survey and detailed hospitalization bills.The cost-effectiveness ratio was deduced by the ratio of direct medical expenses to the improvement amount of MBI and SDS.Results The MBI score,SDS score,proportion of returning position ability in the rapid track group were higher than those in the conventional group,and the differences were statistically significant(t=6.818,-2.333,χ^2=8.126,P<0.001,0.023,0.004);the required expense for MBI increase per 1 point and SDS decrease per 1 point in the rapid track group was lower than that in the conventional group,and the differences were statistically significant(t=-5.419,2.644,P<0.001,0.010).Conclusion Implementing the rapid track of the work-related injury rehabilitation is a economic and effective mode.

关 键 词：脊髓损伤 创伤和损伤 康复介入治疗 治疗结果 费用-效果分析 

分 类 号：R744[医药卫生—神经病学与精神病学] R493[医药卫生—临床医学]