三级康复方案对小儿脑性瘫痪运动功能及治疗成本的影响研究

Effect of three-level rehabilitation program on motor function and treatment cost in children with cerebral palsy

目的探究三级康复方案对小儿脑性瘫痪(简称脑瘫)运动功能及治疗成本的影响。方法 选择2017年10月至2018年10月沈阳市儿童医院康复科收治住院的小儿脑瘫患儿140例,随机分为观察组和对照组各70例。对照组患儿采取常规康复治疗,观察组患儿根据GMFcs分级采用三级康复方案,并对临床疗效及卫生经济学指标进行评价。结果 治疗前两组患儿粗大运动功能评分比较,差异无统计学意义(P>0.05)。治疗后两组患儿评分均较治疗前提高,且观察组患儿评分高于对照组,差异有统计学意义(P<0.05)。观察组患儿的直接医疗费用、直接非医疗费用、间接费用均低于对照组,差异有统计学意义(P<0.05)。结论 构建小儿脑瘫规范化三级康复治疗的分级诊疗模式可以充分利用康复资源,实现成本效益最大化,减轻患者的经济负担。

Objective To explore the effect of three-level rehabilitation program on motor function and treatment cost in children with cerebral palsy. Methods From October 2017 to October 2018,140 children with cerebral palsy were treated in Shenyang Children's Hospital, and they were divided into observation group and control group according to random number table method, 70 in each group. The control group was given routine rehabilitation treatment. The observation group was treated with three-level rehabilitation program according to GMFcs grading, and the clinical efficacy and health economic indicators were evaluated and compared. Results There was no significant difference in gross motor score between the two groups before treatment( P >0.05).After treatment, the scores of the two groups were higher,and the scores of the observation group were higher than those of the control group( P <0.05). The direct medical expenses, direct non-medical expenses and indirect expenses of the observation group were lower than those of the control group, and the difference had statistical significance( P <0.05). Conclusion The construction of a standardized three-level rehabilitation mode for children with cerebral palsy can make full use of rehabilitation resources, maximize cost-effectiveness and reduce the economic burden in the patients.