青少年特发性脊柱侧凸康复治疗卫生经济学初步研究

A preliminary study of the cost-effect evaluation on rehabilitation in patients with adolescent idiopathic scoliosis

目的:对青少年特发性脊柱侧凸患者康复治疗进行成本-效果分析。方法:24例青少年特发性脊柱侧凸患者分为康复治疗组和手术治疗组。康复治疗组12例,采取运动疗法、关节松动、支具治疗;手术治疗组12例,采取手术治疗。治疗前后均应用中文版脊柱侧凸研究学会患者问卷(SRS-22)进行生存质量调查,并在治疗6个月后进行费用调查。结果:治疗6个月后,康复治疗组患者SRS-22问卷自我形象、心理健康维度得分高于治疗前,康复治疗组患者自我形象、对治疗的满意程度维度得分高于手术治疗组(P<0.05)。康复治疗组自我形象维度得分每增加1分所需要的总直接医疗费用为人民币14561.07元,手术治疗组每增加1分所需要的总直接医疗费用为人民币74776.44元。结论:康复治疗是青少年特发性脊柱侧凸经济有效的治疗方案。

Objective： To evaluate the expense of rehabilitation in patients with adolescent idiopathic scohosls I Alb） through the cost-effect analysis, Method： Twenty-four subjects were divided into two groups according to their management： the rehabilitation group received exercise, manipulation and brace; the operation group received surgery. All the subjects were as- sessed with Chinese version of Scoliosis Research Society-22 （SRS-22） health-related quality-of-life （HRQL） questionnaire before and after treatment. At the end of the 6th month, the cost was investigated. Result： At the end of the 6th month, self-image/appearance and mental health for the rehabilitation group were better than before treatment, and self-image/appearance and satisfaction with management were better for the re- habilitation group than for the operation group.The self-image scores were improved 1 point, the total direct medical costs of the rehabilitation group and the operation group were ￥ 14561.07 and ￥ 74776.44 respectively. Conclusion： Rehabilitation is an economical and effective medical strategy for AIS patients.