新疆非胰岛素依赖型糖尿病住院患者强化治疗的成本-效果分析研究
网络出版日期: 2015-03-26
Cost-effectiveness analysis of intensive treatments for in patients with noninsulin-dependent diabetes mellitus in Xinjiang
Online published: 2015-03-26
目的 分析新疆某三甲医院非胰岛素依赖型糖尿病患者住院强化治疗方案的成本-效果,探讨胰岛素泵持续胰岛素皮下注射(CSII)和多次皮下注射胰岛素(MDI)治疗方案的有效性和经济性。方法 本研究采用现况调查的方法,通过成本-效果比、敏感度分析比较两种强化治疗方案的成本-效果。结果 CSII组和MDI组的单位成本分别为6 215.59元和5 809.14元。对于治疗有效病例而言,CSII组和MDI组使血糖达标时间减少1 d所需费用分别为2 972.67元和4 224.83元,使治疗的有效率增加一个百分点所需费用分别为227.36元和929.46元,使达标日的平均血糖下降1 mmol/L所需费用分别为1 246.40元和2 643.53元。敏感度分析的结果与成本-效果比分析的结果是一致的,表明成本-效果分析的结果是稳定和可靠的。结论 CSII治疗方案相对于MDI治疗方案,具有更好的效果,是一种有效、合理、经济的治疗方案。
关键词: 非胰岛素依赖型糖尿病; 胰岛素; 强化治疗; 成本-效果分析
杜亚玲 , 王忠 . 新疆非胰岛素依赖型糖尿病住院患者强化治疗的成本-效果分析研究[J]. 上海交通大学学报(医学版), 2015 , 35(3) : 437 . DOI: 11.3969/j.issn.1674-8115.2015.03.026
Objective To analyze the cost-effectiveness of intensive treatments for inpatients with noninsulin-dependent diabetes mellitus of a grade A tertiary hospital in Xinjiang and explore the effectiveness and economy of continuous subcutaneous insulin infusion (CSII) and multiple daily injections (MDI). Methods The prevalence survey was adopted and the cost-effectiveness of two intensive treatments was compared by the cost-effectiveness ratio and sensitivity analysis. Results The unit costs of CSII group and MDI group were 6 215.59 yuan and 5 809.14 yuan, respectively. For effectively treated cases, the costs of CSII group and MDI group for patients to achieve the normal blood glucose level 1 d earlier were 2 972.67 yuan and 4 224.83 yuan; the costs for effective rate to increase one percent were 227.36 yuan and 929.46 yuan; and the costs for average blood glucose level to decrease 1 mmol/L on the day that the normal blood glucose level was achieved were 1 246.40 yuan and 2 643.53 yuan. The results of sensitivity analysis were consistent with that of the cost-effectiveness ratio analysis, which showed that the results of cost-effectiveness analysis were stable and reliable. Conclusion The effects of CSII treatment are better than those of the MDI treatment. CSII treatment is an effective, reasonable, and economic treatment.
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