中国康复医学杂志
中國康複醫學雜誌
중국강복의학잡지
CHINESE JOURNAL OF REHABILITATION MEDICINE
2009年
12期
1087-1091
,共5页
崔立军%胡永善%沈国光%张安蒙%章亚萍%陈惠芳%沈炜珍%郑钢%于健君%徐一鸣%陈颖%吴毅
崔立軍%鬍永善%瀋國光%張安矇%章亞萍%陳惠芳%瀋煒珍%鄭鋼%于健君%徐一鳴%陳穎%吳毅
최립군%호영선%침국광%장안몽%장아평%진혜방%침위진%정강%우건군%서일명%진영%오의
社区三级康复治疗%随机对照%脑卒中%成本一效果分析
社區三級康複治療%隨機對照%腦卒中%成本一效果分析
사구삼급강복치료%수궤대조%뇌졸중%성본일효과분석
community-based tertiary rehabilitation%randomized controlled trial%stroke%cost-effect analysis
目的:对脑卒中后社区三级康复治疗服务模式进行成本-效果分析.方法:将49例脑卒中患者按社区随机分为康复组和对照组,康复组在常规内科治疗的基础上给予规范的社区三级康复治疗,对照组给予常规内科治疗,没有进行规范的社区康复治疗.分别在入组时、2个月末和5个月未应用临床神经功能缺损程度量表(clinical neural impairment measures SCale,NIM)进行神经功能评定,并进行费用调查.结果:规范的社区三级康复治疗2个月末和5个月末,康复组患者的NIM评分分别平均降低了3.26分和4.74分,对照组平均降低了1.08分和1.84分.康复组患者改善程度均显著优于对照组(P<0.01).在2个月末和5个月末,康复组NIM每降低1分需要的总费用、直接医疗成本、康复治疗费、西药费用分别为￥752.82,￥447.75,￥199.89,￥241.99和￥1176.76,￥647.01,￥255.52,￥382.22;对照组每提高1分需要相关费用分别为￥2760.36,￥1443.69,￥358.30,￥1072.06和￥3899.72,￥1988.45,￥503.91,￥1475.41.对照组约是康复组各项相关费用的2-3倍.结论:社区三级康复治疗服务模式是经济有效的脑卒中社区康复治疗方案.
目的:對腦卒中後社區三級康複治療服務模式進行成本-效果分析.方法:將49例腦卒中患者按社區隨機分為康複組和對照組,康複組在常規內科治療的基礎上給予規範的社區三級康複治療,對照組給予常規內科治療,沒有進行規範的社區康複治療.分彆在入組時、2箇月末和5箇月未應用臨床神經功能缺損程度量錶(clinical neural impairment measures SCale,NIM)進行神經功能評定,併進行費用調查.結果:規範的社區三級康複治療2箇月末和5箇月末,康複組患者的NIM評分分彆平均降低瞭3.26分和4.74分,對照組平均降低瞭1.08分和1.84分.康複組患者改善程度均顯著優于對照組(P<0.01).在2箇月末和5箇月末,康複組NIM每降低1分需要的總費用、直接醫療成本、康複治療費、西藥費用分彆為￥752.82,￥447.75,￥199.89,￥241.99和￥1176.76,￥647.01,￥255.52,￥382.22;對照組每提高1分需要相關費用分彆為￥2760.36,￥1443.69,￥358.30,￥1072.06和￥3899.72,￥1988.45,￥503.91,￥1475.41.對照組約是康複組各項相關費用的2-3倍.結論:社區三級康複治療服務模式是經濟有效的腦卒中社區康複治療方案.
목적:대뇌졸중후사구삼급강복치료복무모식진행성본-효과분석.방법:장49례뇌졸중환자안사구수궤분위강복조화대조조,강복조재상규내과치료적기출상급여규범적사구삼급강복치료,대조조급여상규내과치료,몰유진행규범적사구강복치료.분별재입조시、2개월말화5개월미응용림상신경공능결손정도량표(clinical neural impairment measures SCale,NIM)진행신경공능평정,병진행비용조사.결과:규범적사구삼급강복치료2개월말화5개월말,강복조환자적NIM평분분별평균강저료3.26분화4.74분,대조조평균강저료1.08분화1.84분.강복조환자개선정도균현저우우대조조(P<0.01).재2개월말화5개월말,강복조NIM매강저1분수요적총비용、직접의료성본、강복치료비、서약비용분별위￥752.82,￥447.75,￥199.89,￥241.99화￥1176.76,￥647.01,￥255.52,￥382.22;대조조매제고1분수요상관비용분별위￥2760.36,￥1443.69,￥358.30,￥1072.06화￥3899.72,￥1988.45,￥503.91,￥1475.41.대조조약시강복조각항상관비용적2-3배.결론:사구삼급강복치료복무모식시경제유효적뇌졸중사구강복치료방안.
Objective:To evaluate the expense of communlty-based tertiary rehabilitation in stroke patients through the cost-effect analysis. Method:Forty-nine subjects were randomly divided into two groups according to their community: the rehabilitation group was administered community-based tertiary rehabilitation in addition to routine interventions of internal medicine; the control group was only given the routine ones without standard community-based rehabilitation. All the patients were assessed with clinical neural impairment measure scale (NIM) at the enrolling time, the end of the 2nd month and the 5th month. At the same time, the cost was investigated. Result: There were no significant difference between the two groups in NIM scores at the entering point. However, 2 months and 5 months later, NIM scores decreased 3.26 and 4.74 in the rehabilitation group respertively,while 1.08 and 1.84 in the control group respectively, both differences were significant between the two groups (P<0.01).At the end of the 2nd month and the 5th month decreased one point of NIM score. The total costs, direct medical costs, total rehabilitation costs and medicine costs of the rehabilitation group were ￥752.82,￥447.75,￥199.89,￥241.99 and ￥1176.76,￥647.01 ,￥255.52,￥382.22 respectively, while the costs of the control group were ￥2760.36,￥1443.69, ￥358.30, ￥1072.06 and ￥3899.72,￥1988.45,￥503.91 and ￥1475.41. Conclusion: Community-based tertiary rehabilitation is an economical and effective medical strategy for stroke patients in community.
