对老年冠心病血运重建术后基于物联网平台的医院综合管理模式的药物经济学分析

Pharmacoeconomic analysis of hospital comprehensive management model based on Internet of Things for elderly patients with coronary heart disease after revascularization

目的:探讨基于物联网平台的医院综合管理模式对患者治疗费用的影响。方法:以在某院门诊及病区就诊的老年冠心病血运重建术后患者200例为研究对象,随机分为对照组与观察组各100例。对照组给予常规诊疗及门诊随访管理,观察组给予基于物联网的综合管理模式进行诊治及随访。2组患者均随访12个月,研究前、随访6个月及12个月时采用欧洲五维健康量表评价患者生存质量,计算患者质量调整生命年(QALYs)并作为效用指标;以研究期间患者产生的费用作为成本指标,采用成本-效用分析方法进行药物经济学分析。结果:与对照组相比,观察组在直接成本、间接成本及总成本均明显降低,差异具有显著性(P<0.05);直接成本中,观察组在直接医疗成本及直接非医疗成本均明显低于对照组,差异具有显著性(P<0.05);2组效用值及VAS评分随时间延长呈增加趋势,与随访前相比,随访6个月及12个月时,2组效用值均显著增加且效应值的差异具有显著性(P<0.05);每增加一个质量调整生命年,对照组多花费4 875.53元。结论:基于物联网平台的医院综合管理模是一种经济、有效的老年冠心病血运重建术后管理模式,改善患者生活质量的同时也可节省治疗成本,值得临床参考借鉴。

OBJECTIVE To explore the impact of hospital comprehensive management model based on Internet of Things(IoT)platform on patients’treatment cost METHODS 200 elderly patients with coronary artery disease after revascularization were randomly divided into control group and observation group,with 100 cases in each group.Diagnosis,treatment and outpatient follow-up were performed based on routine management in the control group,while diagnosis,treatment and outpatient follow-up were performed based on comprehensive management model via the Internet of Things in the observation group.Patients in both groups were followed up for 12 months.The Europe Five-dimensional Health Scale was used to evaluate the patients’quality of life before intervention,at 6 months and 12 months after intervention,and QALYs were calculated as a utility index.Pharmacoeconomic analysis was carried out by cost-utility approach.RESULTS Compared with the control group,the direct cost,indirect cost and total cost of the observation group were significantly lower,the difference was statistically significant(P<0.05);The direct cost,the direct medical cost and direct non-medical cost of the observation group were significantly lower than the control group,and the difference was statistically significant(P<0.05);with the extension of follow-up time,the two groups showed an increasing trend of utility value and VAS score.Compared with those before follow-up,at 6 and 12 months of follow-up,the utility value of both groups was significantly increased,and the difference of effect value was significant(P<0.05);the control group spent more 4 875.53 yuan per quality-adjusted life year.CONCLUSION The hospital comprehensive management model based on Internet of Things is an economical and effective management model for elderly patients with coronary heart disease after revascularization.It can improve the quality of life of patients and save the cost of treatment.It is worthy of clinical reference.