脑卒中患者早期康复的临床经济学评价

The clinical economic evaluation of the early rehabilitation treatment for the stroke patients

目的:对脑卒中患者的早期康复进行临床经济学评价。方法:采用随机对照试验,用分层区组随机法将脑卒中患者分入综合康复组及一般康复组。通过观察早期康复对患者临床神经功能缺损程度及日常生活活动能力的影响,采用成本-效果分析对早期康复做相应的临床经济学评价。结果:两组患者基线资料比较差异无显著性意义(P>0.05)。治疗后综合康复组神经功能缺损评分为(7.2±0.5)分,一般康复组为(12.3±0.8)分,日常生活活动评分综合康复组为(73.4±2.1)分,一般康复组为(66.4±2.5)分。综合康复组患者临床神经功能缺损程度每减少1分,需花费人民币1203.2元,日常生活活动能力每提高1分,需花费人民币402.6元;而一般康复组需1715.9,427.6元。结论:早期综合康复在降低患者临床神经功能缺损程度、提高日常生活活动能力上较一般康复有更好疗效,且在改善患者运动功能上更经济。

AIM:To make the clinical economic evaluation on the early rehabilitation in the stroke patients. METHODS:There was no significant difference between the two groups in base line data (P >0.05).The scores on NDS were 7.2±0.5 for the comprehensive rehabilitation group and 12.3±0.8 for the conventional rehabilitation group,while the scores on ADL were 73.4±2.1 and 66.4±2.5 for the two groups, respectively.The patients were allocated randomly into comprehensive rehabilitation group and conventional rehabilitation group.By observation of the neurological deficits scores(NDS) and activities of daily living(ADL) of the stroke patients after rehabilitation,the clinical economic evaluation was made by using cost effectiveness analysis(CEA). RESULTS:The mean costs on comprehensive rehabilitation were $1203.2 and $402.6 fewer for one point lowered in the NDS and increased in the ADL respectively,while the cost on conventional rehabilitation were $1715.9 and $427.6 respectively.The mean costs on the comprehensive rehabilitation were $170.9 and $184.6 fewer than those on the conventional rehabilitation for one point lowered in the NDS and increased in the ADL. CONCLUSION:Early comprehensive rehabilitation treatment is more effective in reducing the NDS and improving the ADL scores in comparison with the general rehabilitation,and it is more economical in improving the motor function of the stroke patients.