分娩镇痛适宜卫生技术经济学效益评价

Economic Benefit Evaluation on Appropriate Health Technology of Delivery Analgesia

目的:对分娩镇痛适宜卫生技术的安全性、有效性、经济性等进行卫生经济学评价。方法:收集河南省临颍、宛城、新密、孟州等4个适宜卫生技术示范县妇幼保健医院足月临产的自然分娩产妇共计156例,将其中72名接受分娩镇痛技术的产妇作为技术组,84名未接受分娩镇痛技术的产妇作为对照组,进行病例对照研究。结果:技术组与对照组新生儿阿氏评分值差别无统计学意义(P>0.05)。分娩镇痛技术不延长产程(P>0.05);技术组分娩过程中疼痛程度低于对照组(P<0.05);技术组医疗费用高于对照组(P<0.05),但是技术组除去椎管内镇痛该部分费用,技术组医疗费用与对照组无统计学差异(P>0.05)。技术组与对照组的增量成本/增量效果比仅为9.21,技术组具有较好的经济效益。结论:分娩镇痛适宜卫生技术可减轻分娩疼痛,不影响母婴健康,椎管内镇痛技术具有安全、有效、性价比高等特点。

Objective：To evaluate the security, effectiveness and economics on appropriate health technology of delivery analgesia. Methods： Case-control study was conducted among 156 lying-in women of full-term birth using natural childbirth in Henan rural areas. 72 lying-in women receiving labor analgesia were selected as technology group, and 84 lying-in women not receiving labor analgesia were selected as control group. The economic benefit evaluation of delivery analgesia technology was analyzed by SAS 9.1 software. Results： There were no statistically significant differences in the comparison of total labor course, Apgar score of newborn between the two groups （P〉0.05）, and the pain of delivery in technology group were significantly lower than that in control group （P〈0.05）. The medical expenses in technology group were significantly higher than that in control group （P〈0.05）. However, excluding medical expenses of spinal canal analgesia, there was no statistically significant differences in the comparison of medical expenses between the two groups （P〉0.05）. The increase cost/increase effectiveness ratio was only 9.21, and the technology group has better economic benefit than that of the control group. Conclusion： The appropriate health technology of labor analgesia could relieve the pain during delivery, which was safe, effective, and economical, and has no adverse impact on outcomes of mothers and infants.