中西医结合卒中单元治疗急性缺血性脑卒中卫生经济学评价

Hygiene Economic Evaluation of Integrative Medicine Stroke Unit for Acute Ischemic Stroke

目的通过前瞻性、多中心、队列对照的研究方法,探讨中西医结合卒中单元治疗急性缺血性脑卒中卫生经济学价值。方法将北京、上海五家三甲医院收集的328例急性缺血性脑卒中病人随机分为中西医结合卒中单元试验组和西医卒中单元对照组。试验组在单纯西医卒中单元常规治疗的基础上,早期介入中药、针灸、推拿、康复等为一体中西医结合综合治疗方案;对照组为西医卒中单元常规治疗结合早期康复锻炼,客观评价两组住院期间以及随访期间的经济成本的差异。结果在住院治疗期间,试验组的治疗费及护理费用高于对照组(P<0.05或P<0.001)。但在3个月及6个月随访期间,试验组的医疗费用及护理费用均低于对照组(P<0.05或P<0.001)。结论中西医结合卒中单元可以明显地减少卒中病人后续治疗的医疗费用,节约社会成本,具有良好的社会效益和经济效益。

Objective To evaluate objectively the economic value of integrative medicine stroke unit for treatment of acute ischemic stroke. Methods Three hundreds and twenty - eight patients with acute ischemic stroke collected from five hospitals in Beijing and Shanghai were divided into integrative medicine stroke unit （treatment group） and modern stroke unit（control group）. The treatment group was treated with the comprehensive intervention of herb, acupuncture, massage,and rehabilitation on the basis of stroke unit standardized treatment. The control group was treated with stroke unit standardized treatment. The economic value of two groups in the period of hospitalization and follow - up were evaluated. Results In the period of hospitalization, the medical expense and care cost in the treatment group was higher than that in control group（P〈0.05 or P〈0. 001）. In the period of 3 months and 6 months follow- up,the medical expense and care cost in the treatment group was lower than that in contol group（P〈0.05 or P〈0. 001）. Conclusion Integrative medicine stroke unit for patients with acute ischemic stroke could significantly reduce the medical expense and care cost.