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安中平,巫嘉陵,周玉颖,何云燕,段建钢.卒中单元的疗效及卫生经济学评价[J].中国康复医学杂志,2008,23(3):225~227
卒中单元的疗效及卫生经济学评价    点此下载全文
安中平  巫嘉陵  周玉颖  何云燕  段建钢
天津市环湖医院神经内科,天津,300060
基金项目:
DOI:
摘要点击次数: 2196
全文下载次数: 2008
摘要:
      摘要 目的:探讨卒中单元对脑卒中患者的疗效及卫生经济学评价,为脑血管病的治疗制订最佳策略。方法:将研究对象分为卒中单元组和普通病房组,疗效观察指标为病死率、平均住院时间、肺感染发生率、治疗前后NIHSS评分、BI评分、改良Rankin评分。采用成本-效果及增量分析进行卫生经济学评价。结果:①出院时卒中单元组各项评分改善程度明显优于普通病房组(P<0.05);②卒中单元组患者的病死率、肺感染率、平均住院时间明显低于普通病房组(P<0.05);③卒中单元组与普通病房组的人均住院费用差异无显著性意义(P>0.05),但在药费、康复治疗、各项检查费用方面比较,差异有显著性意义(P<0.05);④NIHSS评分每减少1分,BI评分每增加1分,MRS评分每减少1分,卒中单元组所需的花费均较普通病房组少。结论:卒中单元能明显促进脑卒中患者神经功能恢复,强调病因学检查,降低病死率和肺感染率,在提高患者疗效上更为经济。 关键词 脑卒中;卒中单元;疗效;成本-效果分析;增量分析 中图分类号:R743,R49 文献标识码:A 文章编号:1001-1242(2008)-03-0225-03
关键词:脑卒中  卒中单元  疗效  成本-效果分析  增量分析
Evaluation on effect and health economics of stroke unit    Download Fulltext
Dept. of Neurology, Tianjin Huanhu Hospital, Tianjin, 300060
Fund Project:
Abstract:
      Objective: To explore effect and health economic evaluation of stroke unit on stroke patients in order to make the best strategy for stroke treatment. Method: Objects of this research were divided into two groups: stroke unit group(SU) and general ward group(GW). The key indexes recorded were case fatality, average length of inpatient stay, lung infection rate, National Institutes of Health Stroke Scale(NIHSS), Barthel index(BI) and modified Rankin scale (MRS). The health economic evaluation was determined by using cost-effectiveness analysis(CEA) and increment analysis. Result:①Compared with GW as leaving hospital, improving extent of various scores in SU were better(P<0.05). ②Case fatality, lung infection rate, average hospitalization duration in SU were less than in GW(P<0.05).③The average expenditure of inpatient had no significant difference between two groups (P>0.05), however the difference in medicine cost, rehabilitation cost and various examining cost were significant(P<0.05). ④The expenditure was less in SU than in GW, when NIHSS reduced one point, BI increased one point and MRS reduced one point respectively. Conclusion: SU could significantly contribute to functional recovery of stroke patients and reduce case fatality and lung infection rate.
Keywords:stroke  stroke unit  effect  cost-effect analysis  increment analysis
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