中西医结合治疗缺血性脑卒中的成本效益分析

Objective:To evaluate the cost-effectiveness of combining Chinese medicine(CM)with Western medicine(WM)for ischemic stroke patients.Methods:Hospitalization summary reports between 2006 and 2010from eight hospitals in Beijing were used to analyze the length of stay(LOS),cost per stay(CPS),and outcomes at discharge.Results:Among 12,009 patients(female,36.44%;mean age,69.98±13.06 years old),a substantial number of patients were treated by the WM_Chinese patent medicine(CPM)_Chinese herbal medicine(CHM)(38.90%);followed by the WM_CPM(32.55%),the WM(24.26%),and the WM_CHM(4.15%).With adjustment for confounding variables,LOS of the WM_CPM_CHM group was about 10 days longer than that of the WM group,and about 6 days longer than that of the WM_CPM group or the WM_CHM group(P0.01);CPS of the WM_CPM_CHM group was United States dollar(USD)1,288 more than that of the WM group,and about USD600 more than that of the WM_CPM group or the WM_CHM group(P0.01).Compared with the WM group,odd ratio(OR)of recovered and improved outcome of the WM_CPM_CHM group was the highest[OR:12.76,95%confidence intervals(CI):9.23,17.64,P0.01],OR of death outcome of the WM_CPM_CHM group was the lowest(OR:0.08,95%CI:0.05,0.12,P0.01).There was no significant difference between LOS,CPS and OR of the WM_CPM group and those of the WM_CHM group(P0.05).Cost/effectiveness and incremental costeffectiveness ratio of the WM_CPM_CHM group were robustly higher than those of the WM group.Conclusion:Compared with WM alone,supplementing CPM and CHM to WM provides significant health benefits of improving the chance of recovered and improved outcome,and reducing the death rate,at an expense of longer LOS and higher CPS.

Cost-Effectiveness Analysis of Combined Chinese Medicine and Western Medicine for Ischemic Stroke Patients

Objective

To evaluate the cost-effectiveness of combining Chinese medicine (CM) with Western medicine (WM) for ischemic stroke patients.

Methods

Hospitalization summary reports between 2006 and 2010 from eight hospitals in Beijing were used to analyze the length of stay (LOS), cost per stay (CPS), and outcomes at discharge.

Results

Among 12,009 patients (female, 36.44%; mean age, 69.98±13.06 years old), a substantial number of patients were treated by the WM_Chinese patent medicine (CPM)_Chinese herbal medicine (CHM) (38.90%); followed by the WM_CPM (32.55%), the WM (24.26%), and the WM_CHM (4.15%). With adjustment for confounding variables, LOS of the WM_CPM_CHM group was about 10 days longer than that of the WM group, and about 6 days longer than that of the WM_CPM group or the WM_CHM group (P<0.01); CPS of the WM_CPM_CHM group was United States dollar (USD) 1,288 more than that of the WM group, and about USD 600 more than that of the WM_CPM group or the WM_CHM group (P<0.01). Compared with the WM group, odd ratio (OR) of recovered and improved outcome of the WM_CPM_CHM group was the highest [OR: 12.76, 95% confidence intervals (CI): 9.23, 17.64, P<0.01], OR of death outcome of the WM_CPM_CHM group was the lowest (OR: 0.08, 95% CI: 0.05, 0.12, P<0.01). There was no significant difference between LOS, CPS and OR of the WM_CPM group and those of the WM_CHM group (P>0.05). Cost/effectiveness and incremental cost-effectiveness ratio of the WM_CPM_CHM group were robustly higher than those of the WM group.

Conclusion

Compared with WM alone, supplementing CPM and CHM to WM provides significant health benefits of improving the chance of recovered and improved outcome, and reducing the death rate, at an expense of longer LOS and higher CPS.