基于META分析的肺结核患者按病种支付方式实施效果研究

目的:收集近20年来国内外学者发表的按病种支付方式下肺结核患者补偿情况的研究,并进行循证医学分析,探寻支付方式对肺结核患者疾病经济负担的作用效果.方法:以"肺结核/结核病"和"支付方式"为关键词,从中国知网、PubMed等数据库检索文献,根据纳入排除标准,利用NoteExpress软件对文献进行筛选,采用RevMan5...

A study on the implementation effect of case-based payment mechanism for tuberculosis patients based on Meta analysis

Objectives:To collect studies on case-based payment from tuberculosis patients published by national and international scholars within the last 20 years,and conduct evidence-based medical analyses in order to explore how changes in the payment model would affect the financial burden of pulmonary tuberculosis patients.Methods:Research articles were retrieved from databases including Chinese National Knowledge Infrastructure(CNKI)and PubMed with the keywords“pulmonary tuberculosis/tuberculosis”and“payment model”.According to the inclusion and exclusion criteria,the articles were screened using NoteExpress software,and Revman5.3 software was used to perform a meta-analysis on results from articles meeting the inclusion criteria.Results:Among 305 articles,only 10 articles met the inclusion criteria.Based on evidence-based medical analysis,the combined risk ratio(RR)for the outcome indicator of reimbursement rate was 1.20 with a 95%confidence interval of[1.11,1.30];on the other hand,analysis on the indicator of personal out-of-pocket costs rendered a standardized mean difference(SMD)of-5.56 with a 95%confidence interval of[-10.05,-1.06].However,the analysis of the outcome indicator of total medical costs revealed no statistically significant difference in the total medical costs of patients before and after the pilot implementation.Conclusions:Case-based payment model helped reduce the financial burden of pulmonary tuberculosis patients to a certain extent.However,the payment model for pulmonary tuberculosis treatment should be further improved.A payment model that is suitable for the prevention and control of pulmonary tuberculosis in China should be explored.