CAJ | 학술논문

目的对经皮冠状动脉介入治疗(PCI)进行成本疗效分析.方法连续收集2006年1月至6月在中国13个城市行PCI的冠心病患者资料.利用SF-36健康调查量表对患者住院期间及出院9个月后的生命质量进行问卷调查,并依此进行成本疗效分析.结果 (1)51.8%接受PCI的冠心病患者年龄在60岁以下.(2)患者住院成本中材料成本占82.5%、西药费占6.8%、手术费占5.9%,这3项共占总住院成本的95.2%,其中支架费用占材料成本的69.8%.(3)术后1年内患者再次入院成本:44例由于发生不良反应事件而再次入院患者的平均再次住院成本为17 841.5元.(4)术后1年内的药物费用:以使用频率最高的5种药(阿司匹林、氯吡格雷、美托洛尔、阿托伐他汀和辛伐他汀)的使用量和价格为依据,通过对患者术后1、3、6、9、12个月的随访调查显示,患者在术后平均每个月的药费为831.5元,每个月药费为400.0元的患者最多.(5)患者治疗后的生命质量显著提高,平均得分提高20.59分;每提高一个分值的生命质量需花费3975.7元;每获得一个质量调整生命年花费59 898.3元.结论我国PCI的成本疗效比在一个较为理想的范围内.
목적 대경피관상동맥개입치료(PCI)진행성본료효분석.방법 련속수집2006년1월지6월재중국13개성시행PCI적관심병환자자료.이용SF-36건강조사량표대환자주원기간급출원9개월후적생명질량진행문권조사,병의차진행성본료효분석.결과 (1)51.8%접수PCI적관심병환자년령재60세이하.(2)환자주원성본중재료성본점82.5%、서약비점6.8%、수술비점5.9%,저3항공점총주원성본적95.2%,기중지가비용점재료성본적69.8%.(3)술후1년내환자재차입원성본:44례유우발생불량반응사건이재차입원환자적평균재차주원성본위17 841.5원.(4)술후1년내적약물비용:이사용빈솔최고적5충약(아사필림、록필격뢰、미탁락이、아탁벌타정화신벌타정)적사용량화개격위의거,통과대환자술후1、3、6、9、12개월적수방조사현시,환자재술후평균매개월적약비위831.5원,매개월약비위400.0원적환자최다.(5)환자치료후적생명질량현저제고,평균득분제고20.59분;매제고일개분치적생명질량수화비3975.7원;매획득일개질량조정생명년화비59 898.3원.결론 아국PCI적성본료효비재일개교위이상적범위내.
Objective To investigate the cost-utility of percutaneous coronary intervention(PCI)in China.Mcthods A total of 630 patients from 13 cities undergoing PCI during the first half year of 2006 were enrolled in this study.The 36 items derived from the short form of health survey(SF-36)were applied prospectively in these patients before and 9 months after PCI.The cost per every incremental mark of SF-36 and quality adjusted life year(QALY)were calculated.Results(1)The age was lower than 60 years old in more than 50%patients.(2)In terms of detailed costs,material costs accounted for 82.5%of the hospitalization costs.medications costs accounted for 6.8%,and operation fee accounted for 5.9%.These 3 iterns comprised 95.2% of overall hospitalization costs,and 69.8% material costs were the cost for stents.(3)The average re-admission hospitalization costs were 17 841.5 RMB in 44 patients who were rehospitalized due to occurrence of major adverse cardiac events.(4)Follow-up made at months 1,3,6,9,and 12 post index procedure showed that an average cost for postoperative drug treatment was 831.50RMB per month,and most patients spent 400.0 RMB for drug treatment per month.(5)The average quality of life score increased by 20.59 post PCI(P<0.05 vs.pre-PCI).The cost-effective analysis indicates that the cost per every incremental mark of SF-36 was 3975.7 RMB.The cost per every QALY gained was 59 898.3 RMB.Conclusion PCI is effective for patients with coronary heart disease and the cost per QALY in China was positioned in an acceptable range.