手外伤康复治疗的成本-效果研究

The cost-effectiveness analysis of rehabilitation on hand injury patients

目的:对手外伤住院患者康复治疗作成本-效果的经济学分析评价。方法:对50例手外科住院的指屈肌腱损伤患者按配对对照原则随机分成康复组和对照组,康复组给予手外科常规治疗加规范的早期系统康复治疗,对照组给予手外科常规治疗加指导性功能训练。分别采集两组患者自发病到发病后3个月的直接医疗费用,以及各费用的详细构成。对于每例患者在发病后1、2、3个月时分别进行手关节总主动活动度(TAM)评定、明尼苏达手灵巧度评定(MMDT)、普渡手精细运动评定(PPT)系统进行手功能的评价。结果:康复组患者的功能改善明显较对照组为佳,两组患者总费用之间差异无显著性;不论是手关节TAM、手灵巧度,还是手精细运动功能评分每改善1分,康复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康复组的1—2倍。结论:手外伤患者的规范早期系统康复治疗是经济的、有效的治疗方案。

Objective：To analyze the cost-effectiveness of rehabilitation on hand injury patients.Method：All 50 hospitalized patients with injury of digital flexor tendons were divided into treated group and control group randomly. Patients in treated group were given early rehabilitation, while those in control group were only given routine hand surgery medicine treatments that were the same as in treated group but without early rehabilitation. Direct medical costs used for every patient, and detailed buildups of every cost during the 3rd month post hand injury were collected. All patients were assessed with tendon total active motion （TAM）, Minnesota manual dexterity （MMDT） and Purdue pegboard assessment systems （PPT）, at the end of 1st, 2nd and 3rd month post hand injury respectively. Result： The function improvement in treated group was better than that in control group. There was no significant difference between two groups in total medical costs. For the function improvement of hand muscles strength, Minnesota manual dexterity, Purdue pegboard and active range of motion, the expenditure used for every single point of function improvement in treated group was significantly lower than those in control group; In control group it was 1-2 times higher than that in treatment group. Conclusion：The rehabilitation is an economical and effective treatment for hand injury patients.