动态血压监测应用于社区高血压诊断的卫生经济学评价  

Health Economics Study on the Application of Ambulatory Blood Pressure Monitor in the Diagnosis of Hypertension in Community

作　　者：刘克军 陈伟伟[2] LIU Ke-Jun;CHEN Wei-Wei(National Health Development Research Center,Beijing 100044,China;National Center for Cardiovascular Diseases,Fuwai Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 102300,China)

机构地区：[1]国家卫生健康委卫生发展研究中心,北京100044 [2]国家心血管病中心中国医学科学院阜外医院,北京102300

出　　处：《中国药物经济学》2020年第11期25-28,共4页China Journal of Pharmaceutical Economics

摘　　要：目的评价动态血压仪应用于社区高血压监测的经济学。方法选取15家较早使用动态血压监测的医院,运用成本-效益分析法,结合文献提供的相关参数,比较分析诊室血压测量(OBPM)和动态血压测量(ABPM)的经济学。结果ABPM例均成本为52.07元。针对新发疑似病例,白大衣性高血压检出率8.62%,夜间高血压检出率89.32%;针对高血压前期者,隐匿性高血压检出率超过70%;既往诊断高血压患者中,诊室血压未控制者的白大衣性未控制性高血压检出率10.27%、夜间血压不达标者81.16%,诊室血压已控制者的夜间血压不达标检出率71.46%。医院每监测1新发疑似病例和高血压患者,未来可节省至少3093.54元不必要的脑卒中并发症的医药费用支出。4)最保守估计,动态血压监测成本-效益比为1∶12.63。结论动态血压监测具有较高的经济学。Objective To evaluate the economics of ambulatory blood pressure apparatus in community hypertension monitoring.Methods A total of 15 hospitals that used ABPM earlier were selected to compare the economy between OBPM and ABPM by using cost-benefit analysis method.Results The average cost of ABPM cases was 52.07 yuan.For new suspected cases,the detection rate of white coat hypertension was 8.62%,and the detection rate of nocturnal hypertension was 89.32%;for pre-hypertension,the detection rate of occult hypertension exceeded 70%;among previously diagnosed hypertension patients,the detection rate of white coat uncontrolled hypertension among those with uncontrolled blood pressure in the office was 10.27%,and those who did not meet the standard at night was 81.16%.The detection rate of those with controlled blood pressure at night was 71.46%.For every new suspected case and hypertensive patient monitored by the hospital,it can save at least RMB 3,093.54 in medical expenses for unnecessary stroke complications in the future.For the most conservative estimate,the cost-benefit ratio of ambulatory blood pressure monitoring was 1:12.63.Conclusion ABPM has high economic benefits result.

关 键 词：动态血压 成本测算 经济学评价 

分 类 号：R544.1[医药卫生—心血管疾病] R956[医药卫生—内科学]