中西医结合治疗白血病成本效果分析

CJI (Traditional Chinese Medicine) - - Chinese Journal Of Information On Traditional Chin -

季聪华,洪雪文,邵琼,刘姗,张颖,李秋爽

浙江省中医院临床评价分析中心,浙江 杭州 310006

摘要:目的 分析浙江省中医院白血病中西医结合治疗的卫生经济学特征,评价血液病学科临床诊治水平和管理水平的提升趋势。方法 检索 2010 年1月- 2015 年 12月浙江省中医院病案信息数据库及电子病历系统,按照纳入与排除标准筛选出符合条件的白血病患者资料,分别以住院总费用、西药费、中成药费、饮片费、输血费作为成本,以血常规白细胞计数( WBC)、血红蛋白浓度( HGB)、血小板计数( PLT)作为效果指标进行成本效果分析。结果 WBC偏低患者提升单位WBC、WBC偏高患者降低单位WBC、HGB偏低患者提升单位HGB及 PLT偏低患者提升单位PLT所花费的住院总费用、西药费、中成药费、饮片费和输血费,大致上均有逐年下降的趋势。结论 中西医结合治疗白血病化疗后三大血常规指标改善的卫生经济学优势逐年提高。关键词:白血病;成本效果;卫生经济学

DOI: 10.3969/j.issn.1005-5304.2017.02.012

中图分类号: R273.37 文献标识码: A 文章编号: 1005-5304(2017)02-0040-04

Cost Effectiveness Analysis on Integrated Traditional Chinese and Western Medicine in Treatment of Leukemia

JI Cong-hua, HONG Xue-wen, SHAO Qiong, LIU Shan, ZHANG Ying, LI Qiu-shuang (Clinical Evaluation and Analysis Center, Zhejiang Province Hospital of TCM, Hangzhou 310006, China)

Abstract: Objective To analyze the features of health economics in the treatment of leukemia; To evaluate the improvement trend of levels of clinical diagnosis, treatment and management. Methods TCM medical information dtatabase and electronic medical system in Zhejing Province TCM Hospital from January 2010 to December 2015 were retrived. According to inclusion and exclusion criteria, leukemia patients’ materials that met the critiria were screened. The total hospitalization fees, cost of Western medicine, the cost of Chinese patent medicine, cost of TCM decoction pieces, and cost of blood transfusion were set as costs, while white blood cell count, hemoglobin concentration, and platelet count were set as effectiveness indicators for cost effectiveness analysis. Results In patients with low white blood cell count increased unit white blood cell count, patients with high white blood cell count declined unit white blood cell count, patients with low hemoglobin increased unit hemoglobin count and patients with low platelet count increased unit platelet count, the total hospitalization fees, cost of Western medicine, the cost of Chinese patent medicine, cost of TCM decoction pieces, and blood transfusionfor the above increases showed a decreasing trend. Conclusion Health economics advantages in three blood routine indicators after treatment of integrated traditional Chinese and western medicine for leukemia is increasing year by year.

Key words: leukemia; cost effectiveness analysis; health economics

白血病是血液系统恶性肿瘤,目前治疗以化疗为主。中医药可以减轻化疗药的毒副作用,起到减毒增

[1]

效的作用 。在不同化疗阶段针对不同证型分别使用不同中药进行辨证施治,可明显提高患者机体耐受力、防止胃肠道反应及减少感染,提升因化疗而受到抑制的血液三大常规指标。而对于白血病这样具有重 基金项目:国家中医药管理局中医临床研究基地业务建设专项( JDZX2012172 );浙江省中医药优秀青年人才基金计划(2012ZQ012) 大人群危害的疾病,卫生经济学评价仅有少量报道[ 2],因此有必要从卫生经济学的角度评价中医药的作

[3]

用 。本研究利用医院日常诊疗数据库从成本和效果

2 方面对中西医结合治疗白血病的价值做卫生经济学评价。

1 资料与方法

1.1 数据来源

资料来源于浙江省中医院病案信息数据库及电子病历系统。通过制定信息检索规则进行数据检索,输出患者住院天数、住院期间费用等基本信息,并同

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