脑卒中患者早期康复治疗的成本-效果分析

The cost-effectiveness analysis of early rehabilitation of stroke patients

目的 对脑卒中患者三级康复治疗期间的第一阶段康复治疗作成本 效果的经济学分析评价。方法 5 2例脑卒中患者在脑梗死和脑出血二个层次上按区组随机化纳入到治疗组和对照组。治疗组给予规范的一级早期康复治疗 ;对照组不给予规范的一级早期康复治疗 ,但是一般的常规内科治疗同治疗组。分别采集 2组患者自发病到发病后 1个月的直接医疗费用、直接非医疗费用和间接费用以及各费用的详细构成。对每例样本在入选时 (V0 )和发病后第 1个月 (V1)分别采用功能综合评定量表进行评价。结果 治疗组患者的功能改善明显较对照组为佳 ,2组患者总费用之间无明显差别 ;不管是运动功能、认知功能 ,还是综合功能评分每改善 1分 ,治疗组所耗费的相关成本费用明显较对照组为低 ,对照组相关费用约是治疗组的 3～ 5倍。结论 三级康复中的第一阶段康复治疗 ,即一级早期康复是经济的、有效的康复治疗方案。

Objective To analyze the cost-effectiveness of the first stage early rehabilitation of stroke patients administered with standardized three stages of rehabilitation interventions. Methods All 52 patients firstly were brought into two blocks: primary cerebral infarction and primary cerebral hemorrhage then were divided into treatment group and control group randomly. Patients in the treatment group were given the first stage early rehabilitation of the standardized three stages of rehabilitation, while those in the control group were only given normal internal medication treatments that were the same as the treatment group but without first stage early rehabilitation. All patients were assessed with the scale of Functional Comprehensive Assessment (FCA), at the entry and the end of 1st month, respectively, after stroke. Results The functional improvement of the treatment group was better than that of the control group. There was no obvious difference between the two groups with regard to the total costs. Regardless of motor, cognitive or comprehensive function, expenditure used for every one single point improvement with the function of the treatment group,was significantly lower than those of the control group. The costs of the control group were 3～5 times of those of the treatment group. Conclusion The first stage early rehabilitation of stroke patient subject to the standardized three stages of rehabilitation intervention was an economical and effective intervention scheme to stroke patients.