CAJ | 학술논문

目的分析不同康复模式对小儿脑性瘫痪产生的经济学效果.方法将153例脑瘫患儿分为医院-社区-家庭康复组(n=52)、医院内康复组(n=50)和无干预措施组(n=51),分别施行医院-社区-家庭康复模式、医院内康复模式和无干预措施治疗.3组均于入组时、第3和第6个月采用粗大运动功能-88评估表(GMFM-88)、费用统计表进行评估.结果入组时,3组患儿粗大运动功能各项经统计学分析,差异无统计学意义(P>0.05);第3和第6个月,医院-社区-家庭康复组与医院内康复组患儿和无干预措施组比较,其粗大运动功能的总百分比、月百分比和月相对百分比差异均有统计学意义(P<0.01);但无干预措施组内差异无统计学意义.第3和第6个月后医院-社区-家庭康复组粗大运动功能评分每提高1分的费用分别为(101.87±97.59)元,(75.11±45.75)元,而医院内康复组为(387.21±54.76)元,(170.31±123.16)元,前者比后者低2～3倍,两组间差异有统计学意义(P<0.01).结论医院内康复适用于肺瘫患者的早期康复,而医院-社区-家庭康复适用于脑瘫患儿的长期康复,且可减少患儿康复费用的支出,是比较适合我国国情的一种脑瘫康复模式.
목적 분석불동강복모식대소인뇌성탄탄산생적경제학효과.방법 장153례뇌탄환인분위의원-사구-가정강복조(n=52)、의원내강복조(n=50)화무간예조시조(n=51),분별시행의원-사구-가정강복모식、의원내강복모식화무간예조시치료.3조균우입조시、제3화제6개월채용조대운동공능-88평고표(GMFM-88)、비용통계표진행평고.결과 입조시,3조환인조대운동공능각항경통계학분석,차이무통계학의의(P>0.05);제3화제6개월,의원-사구-가정강복조여의원내강복조환인화무간예조시조비교,기조대운동공능적총백분비、월백분비화월상대백분비차이균유통계학의의(P<0.01);단무간예조시조내차이무통계학의의.제3화제6개월후의원-사구-가정강복조조대운동공능평분매제고1분적비용분별위(101.87±97.59)원,(75.11±45.75)원,이의원내강복조위(387.21±54.76)원,(170.31±123.16)원,전자비후자저2～3배,량조간차이유통계학의의(P<0.01).결론 의원내강복괄용우폐탄환자적조기강복,이의원-사구-가정강복괄용우뇌탄환인적장기강복,차가감소환인강복비용적지출,시비교괄합아국국정적일충뇌탄강복모식.
Objective To analyze the economic effects of different rehabilitation patterns for children suffering from cerebral palsy. Methods A total of 153 cerebral palsy patients were divided into a hospital-community-family rehabilitation group(n = 52), a hospital rehabilitation group (n = 50) and a non-intervention control group (n = 51). Those in the first group were provided with a hospital-community-family rehabilitation therapy pattern, those in the sec-ond only hospital rehabilitation and the third no intervention. All the patients were evaluated using the Gross Motor Function Measure-88 (GMFM-88) Scale and the Cost Measure Scale at admission, and at the end of the 3rd and 6th months of treatment. Results There were no significant differences in gross motor function among the three groups at admission. At the end of the 3rd month and the 6th month there were significant differences between the children in the hospital-community-family rehabilitation program and those in the hospital rehabilitation program in terms of gross motor function. Their general percentage, monthly percentage and monthly relative percentage results were all significantly different. But there was no significant difference in the non-interventian control group since admission. Every unit of improvement in gross motor function cost $101.87±97.59, $75.11±45.75 in the hospital-community-family reha-bilitation program and $387.21±54.76, $170.31±123.16 in the hospital rehabilitation program at the end of the 3rd and the 6th month respectively. So the cost of the former was only about 30% of the latter. Conclusion Hospital rehabilitation is suitable for the early rehabilitation of cerebral palsy children. Hospital-community-family rehabilitation is better for long-term rehabilitation of cerebral palsy children, and what is more, it can decrease the rehabilitation ther-apy cost substantially. So a hospital-community-family rehabilitation pattern is more compatible with China's national situation.