头孢类皮试费用及其不良反应的经济学对比分析

Economic Comparative Analysis of Cost and Adverse Reactions of Cephalosporin Skin Test

目的:探讨头孢类皮试费用及其不良反应的经济学对比分析。方法:回顾性分析2016年1月-2017年7月本院常用的8种头孢类抗生素的皮试相关情况,包括注射液头孢哌酮钠舒巴坦钠、注射用头孢曲松钠、注射用头孢呋辛钠、注射用头孢他啶、注射用头孢硫脒、注射用头孢唑肟钠、注射用头孢曲松钠他唑巴坦钠、注射液头孢头孢孟多酯钠。分析其皮试成本费用以及由于头孢菌素类注射剂过敏反应所产生的相关费用。结果:2016年1月-2017年7月本院使用过上述的8种头孢类抗生素的患者有8 108例,皮试阳性率为0.160%,皮试直接成本为22 459.16元,间接成本为0元;患者承担的费用(含皮试用药品)为18 606.50元,医保承担的费用为411 116.34元,全社会承担的费用为429 722.84元。8 108例使用头孢菌素类注射剂的患者中,输液中过敏3例,治疗过敏反应的直接成本为379.17元,平均成本为126.39元,间接成本为误工费0,平均0元,由于发生过敏反应所产生的诉讼及赔偿费用为0元,平均为0元,合计过敏反应成本平均126.39元。从全社会角度分析,8种头孢菌素类注射剂的总皮试成本为429 722.84,平均皮试成本为(50.70±1.12)元明显低于通过过敏反应平均成本为(126.39±2.35)元,差异有统计学意义(t=75.32,P<0.001)。结论:头孢菌素类注射剂的皮试结果低阳性率、药品费用高成本,其不良反应过敏治疗产生的成本更高。为减少患者的经济负担,重视过敏反应,在保障用药安全的前提下进行规范化皮试管理。

Objective:To investigate the comparative analysis of the cost of Cephalosporin and its adverse reactions.Method:A retrospective analysis of our hospital from January 2016 to July 2017,eight kinds of common skin test related situation of Cephalosporin Antibiotics,including Cefoperazone Sodium and Sulbactam Sodium for Injection,Ceftriaxone Sodium for Injection,Cefuroxime Sodium For Injection,Ceftazidime for Injection,Cephathiamidine for Injection,Ceftizoxime Sodium for Injection,Ceftriaxone Sodium and Tazobactam Sodium for Injection,Cefamandole Nafate for Injection.The cost of the skin test and the related costs associated with the allergy of cephalosporin injection were analyzed.Result:From January 2016 and July 2017,our hospital used the above during the period of 8 kinds with 8 108 cases of Cephalosporin Antibiotics skin test positive rate was 0.160%,skin test cost was 22 459.16 yuan directly,the indirect costs of 0 yuan.The cost of the patient’s expenses(including the skin trial medicine)was 18 606.50 yuan,and the cost of medical insurance was 41 116.34 yuan,the total social cost was 429 722.84 yuan.8 108 patients of Cephalosporins type of injection,the infusion of allergy in 3 cases,direct cost was 379.17 yuan for the treatment of allergic reactions,the average cost was 126.39 yuan,the indirect costs for lost was 0 yuan,the average cost was 0 yuan,resulting from an anaphylactic reaction and compensation lawsuit cost was 0,the average cost was 0 yuan,the average cost of total allergy costs was 126.39 yuan.From the perspective of the whole society,the total skin test cost of 8 kinds Cephalosporins was 429 722.84 yuan.The average skin test cost was(50.70±1.12)yuan,which was significantly lower than(126.39±2.35)yuan of the allergic reaction,the difference was statistically significant(t=75.32,P<0.001).Conclusion:The skin test results of Cephalosporin Injection are low positive and high cost,and the cost of allergic reaction is higher.To reduce the economic burden of patients,we should pay attention to the allergic reaction and conduct standardized skin test management on the premise of ensuring the safe use of drugs.