分娩镇痛技术在县级医疗机构应用的卫生经济学分析

目的 分析分娩镇痛技术在县级医疗应用的成本及效果,为促进其在基层医疗机构的推广应用提供客观依据.方法 选择2010年7～8月在河南省新密市妇幼保健院及新密市中医院就诊的165例孕产妇作为研究对象,按分娩日期随机分配为分娩镇痛组和非分娩镇痛组.分娩镇痛组80例,非分娩镇痛组85例,分析两组患者在分娩过程中的痛苦评分、费用等指标.结果 从视觉模拟评分（VAS）的减少情况来看,分娩镇痛组平均减少2.96分,而非分娩镇痛组减少-0.37分（即增加了0.37分）;从疼痛减轻的效果来看,分娩镇痛组的成本-效果比为498.66,非分娩镇痛组的成本效果比为1207.31.据此推算,每减轻1个疼痛评分值,非分娩镇痛组的成本为分娩镇痛组的2.42倍.结论 分娩镇痛技术镇痛效果好,县级医疗机构应用符合成本-效果原则,应采取措施促进该项技术在基层的推广应用.

Health economics analysis of labor analgesia used in county-level medical institutions

Objective To analyze the cost and effect of labor analgesia used in county-level medical institutions and to provide some basis for promoting the popularization and application of labor analgesia.Methods In Maternal and Child Care Service Centre and Hospital of Traditional Chinese Medicine of Xinmi City,165 pregnant women who were giving birth to the baby from July to August in 2010 were selected as study object and randomly divided into the analgesia labor group and non-analgesia labor group according to the date of delivery.There were 80 cases in analgesia labor group and 85 cases in non-analgesia labor.Pain scoring and cost during delivery of two groups were analyzed.Results Reduction of visual analogue scale （VAS） was 2.96 points in analgesia labor group while-0.37 points （increase of 0.37 points） in the non-analgesia labor group.As for the pain relief effect,cost effectiveness ratio was 498.66 in analgesia labor group,while 1207.31 in the non-analgesia labor group.Accordingly,when reducing 1 pain score,the cost of non-analgesia labor group was 2.42 times of the analgesia labor group.Conclusion Analgesia labor technology plays great role in reducing pain of pregnant women during delivery and the application of labor technology accords with cost-effect principle,measures should be taken to promote the application of this technology in basic medical institutions.