脑卒中患者早期强化康复治疗的卫生经济学评价

目的:中国的脑卒中康复缺少强化康复与一般康复的对照研究,亦无早期康复的卫生经济学评价。对脑卒中患者早期康复进行卫生经济学评价,观察早期强化康复后患者能否缩短住院日,减少医疗费用。方法:用分层区组随机法将患者分入两组。用成本效果分析进行卫生经济学评价。结果:强化康复组患者神经功能缺损积分每减少1分、总的生活能力每提高1级、日常生活活动能力每提高1分需分别花费人民币1267.8元、6508.0元和411.0元。而一般康复组则分别需花费1875.4元、10462.4元和2422.1元。2组患者住院时间及医疗费用无显著性差异。结论:早期强化康复在降低患者神经功能缺损积分、提高患者总的生活能力等级及日常生活活动能力上较一般康复有更好疗效。强化康复在脑卒中早期康复中更为经济。

The economic health evaluation to the early intensive rehabilitation on patients with stroke

AIM:There is no study in intensive rehabi litation compared with conven-tional one and no economic health evaluation in early rehabilitation to t he stroke patients in China.We did it to the early rehabilitation on the pati ents with stroke and observed whether early intensive rehabilitation was abl e to shorten the length of hospital stay a nd reduce the medical costs in stroke patients.METHODS:The patients were allocated randoml y to intensive re-habilitation and conventional grou p.We did the economic health evaluation using cost-effectiveness analysis.RESULTS:The neurological deficit scores were reduced 1point,total activity ability and ADL scores were improved1point,the costs were 1267.8,6508.0and 411.0Yuan RMB prospectively in stroke patients whom were given earlier intensive rehabilitation;th e con-trolled group were 1875.4,10462.4a nd 2422.1Yuan RMB.But the length of hospital stay and medical c osts had no significant difference i n the two groups.CONCLUSION:Early intensive rehabilitation services were more effective in reducing the strok e patient ' s neurological deficit and im-proving the ADL scores in comparison with the general rehabilitation.The cost-effectiveness analysis showe d that early intensive rehabilitation is more economic.