分娩镇痛适宜卫生技术经济学效益评价

目的:对分娩镇痛适宜卫生技术的安全性、有效性、经济性等进行卫生经济学评价。方法:收集河南省临颍、宛城、新密、孟州等4个适宜卫生技术示范县妇幼保健医院足月临产的自然分娩产妇共计156例,将其中72名接受分娩镇痛技术的产妇作为技术组,84名未接受分娩镇痛技术的产妇作为对照组,进行病例对照研究。结果:技术组与对照组新生儿阿氏评分值差别无统计学意义(P>0.05)。分娩镇痛技术不延长产程(P>0.05);技术组分娩过程中疼痛程度低于对照组(P<0.05);技术组医疗费用高于对照组(P<0.05),但是技术组除去椎管内镇痛该部分费用,技术组医疗费用与对照组无统计学差异(P>0.05)。技术组与对照组的增量成本/增量效果比仅为9.21,技术组具有较好的经济效益。结论:分娩镇痛适宜卫生技术可减轻分娩疼痛,不影响母婴健康,椎管内镇痛技术具有安全、有效、性价比高等特点。

Economic Benefit Evaluation on Appropriate Health Technology of Delivery Analgesia

Objective:To evaluate the security,effectiveness and economics on appropriate health technology of delivery analgesia.Methods:Case-control study was conducted among 156 lying-in women of full-term birth using natural childbirth in Henan rural areas.72 lying-in women receiving labor analgesia were selected as technology group,and 84 lying-in women not receiving labor analgesia were selected as control group.The economic benefit evaluation of delivery analgesia technology was analyzed by SAS 9.1 software.Results:There were no statistically significant differences in the comparison of total labor course,Apgar score of newborn between the two groups(P>0.05),and the pain of delivery in technology group were significantly lower than that in control group(P<0.05).The medical expenses in technology group were significantly higher than that in control group(P<0.05).However,excluding medical expenses of spinal canal analgesia,there was no statistically significant differences in the comparison of medical expenses between the two groups(P>0.05).The increase cost/increase effectiveness ratio was only 9.21,and the technology group has better economic benefit than that of the control group.Conclusion:The appropriate health technology of labor analgesia could relieve the pain during delivery,which was safe,effective,and economical,and has no adverse impact on outcomes of mothers and infants.