3种经验性抗感染治疗方案对老年非重症社区获得性肺炎的成本-效果分析

Cost-Effectiveness Analysis of Three Empirical Anti-infective Treatment Regimens for Elderly Patients with Non-severe Community-acquired Pneumonia

目的:分析和比较3种经验性抗感染治疗方案对老年非重症社区获得性肺炎(community-acquired pneumonia,CAP)的成本-效果状况,为临床经济有效地治疗老年非重症CAP提供参考。方法:选取2022年3月—2023年3月南通市第一人民医院收治的105例老年非重症CAP患者作为研究对象,根据治疗方案的不同将其分为A组(35例,予莫西沙星治疗)、B组(39例,予头孢噻肟-舒巴坦钠治疗)和C组(31例,予莫西沙星+头孢噻肟-舒巴坦钠治疗),比较3组患者的疗效、安全性、治疗费用和成本-效果比。结果:A组、B组和C组患者用药治疗后的总有效率分别为74.29%、76.92和87.10%,而其用药期间药物不良反应的发生率分别为5.71%、2.56%和3.23%,其总有效率和药物不良反应发生率经两两比较其差异均无统计学意义(P>0.05);A组、B组和C组患者的平均总住院费分别为(11 337.70±1 348.50)元、(14 261.80±1 401.30)元和(17 085.70±1 563.40)元,而其平均总药费分别为(4 226.00±691.60)元(、6 237.50±715.90)元和(7 642.70±764.80)元,其中B组、C组的平均总住院费和平均总药费均显著高于A组(P<0.05);成本-效果分析结果显示,A组、B组和C组患者的成本-效果比(C/E)分别152.61、185.41和196.16。结论:3种经验性抗感染治疗方案对老年非重症CAP患者的疗效和安全性基本相当,单用莫西沙星治疗的经济性更好。

Objective:To analyze and compare the cost-effectiveness of three empirical anti-infective treatment regimens for elderly patients with non-severe community-acquired pneumonia(CAP),and to provide reference for clinical and economically effective treatment of elderly patients with non-severe CAP.Methods:105 elderly patients with non-severe CAP admitted to the First People's Hospital of Nantong from March 2022 to March 2023 were selected as the research subjects.According to different treatment regimens,they were divided into Group A(35 cases,treated with moxifloxacin),Group B(39 cases,treated with cefotaxime-sulbactam sodium),and Group C(31 cases,treated with moxifloxacin + cefotaxime-sulbactam sodium).The efficacy,safety,treatment costs and cost-effectiveness ratio of three groups of patients were compared.Results:The total effective rates of patients in Group A,Group B and Group C after medication treatment were 74.29%,76.92% and 87.10% respectively,while the incidence rates of adverse drug reaction during the medication period were 5.71%,2.56% and 3.23% respectively.There was no statistical significance of difference between the total effective rate and the incidence rate of adverse drug reaction after pairwise comparison(P>0.05).The average total hospitalization expenses of patients in Group A,Group B and Group C were(11 337.70±1 348.50) yuan,(14 261.80±1 401.30) yuan and(17 085.70±1 563.40) yuan respectively,while their average total drug expenses were(4 226.00±691.60) yuan,(6 237.50±715.90) yuan and(7 642.70±764.80) yuan respectively.The average total hospitalization expenses and average total drug expenses of Group B and Group C were significantly higher than those of Group A(P<0.05).The cost-effectiveness analysis results showed that the cost-effectiveness ratios(C/E) of patients in Group A,Group B and Group C were 152.61,185.41 and 196.16 respectively.Conclusion:The efficacy and safety of three empirical anti-infective treatment regimens are basically equivalent for elderly patients with non-severe CAP,and treatment with moxifloxacin alone is more cost-effective.