卒中单元的疗效及卫生经济学评估

Evaluation on effect and health economics of stroke unit

目的探讨卒中单元的卫生经济学效益,为脑卒中的治疗和评估提供有效方法。方法通过对卒中单元建立后3年2 220例脑卒中患者与建立前3年1 797例脑卒中患者综合疗效和卫生经济学指标对比研究,比较脑卒中单元的疗效及卫生经济学指标。结果脑梗死对照组和卒中单元组临床疗效差异有统计学意义(Z=10.986,P<0.01),脑出血对照组和卒中单元组临床疗效差异有统计学意义(Z=4.503,P<0.01)。卒中单元建立后脑梗死住院天数由12天降低到11天,住院费由3 586.24元提高至3 625.97元,药品费占总费用比例由0.42降低至0.36(Z=6.310、2.859、11.362,均P<0.01);脑出血住院费由5 319.65元提高至6 116.96元(Z=2.692,P<0.01)。综合满意度由90.8%提高到97.4%(χ2=77.431,P<0.01)。结论卒中单元提高了脑卒中疗效、卫生经济学效益及满意度。

Objective To explore the effect of the health economics for stroke on stroke patients in order to offer the effective method for the therapy and evaluation of stroke. Methods The suitable stroke patients were divided into two groups：the stroke unit group contained 2 220 patients during three years after stroke unit establishment and the general group contained 1 797 patients during three years before the stroke unit establishment,to record the target of total effect and health economics to evaluate the effect on health economic. Results There was significant difference in the clinical efficacy between the control group and the stroke unit for cerebral infarction（ Z = 10. 986, P d0.01） and cerebral hemorrhage（ Z = 4. 503, P d0. 01）. Compared to the control group, cerebral infarction in the hospital day（12 days to 11 days） ,the cost （3 568.24 yuan to 3 625.97 yuan）, the drug-use rate （0.42 to 0.36） all showed significant difference（ Z =6. 310,2. 859,11. 362,all P d0.01） cerebral hemorrhage in the cost（5 319.65 yuan to 6 116.96 yuan） showed significant difference（ Z = 2. 692, P 〈0.01）. The satisfaction 97.4% showed remarkable increase（x^2=77. 431, P 〈0.01）. Conclusion The stroke unit increases the effects of the therapy, evaluation on health economics and satisfaction of stroke patients.