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老年医疗保险制度(Medicare)晚期肾病计划已引起人们的关注,它已成为政府医疗费用高支出的典型。在过去的十年中,肾移植的数量明显地增加,移植的成功率也有所提高。从1980年~1985年,肾移植数每年增加10%。在此期间,死者与活者捐献的移植器官成活率分别增加7%和3%。成功的一部分因素是由于环孢菌素的引进。肾移植成功率的提高,使晚期肾病Medicare计划受益人组中,移植组增长快。到1985年底,肾移植在所有受益者中占18%;在55岁以下受益者中占32%。1983年初,在最年幼组中,肾移植达到足以减少透析病人的绝对数水平。因为病人进行移植的花费只是透析花费的三分之一,且生命质量更好,所以肾移植对于晚期肾病的患者来说有着最好的临床和经济后果。
The Medicare advanced kidney disease plan has attracted people’s attention, and it has become a typical example of the government’s high expenditure on medical expenses. Over the past decade, the number of kidney transplants has increased significantly and the success rate of transplants has also increased. From 1980 to 1985, the number of kidney transplants increased by 10% annually. During this period, the survival rate of transplanted organs donated by the deceased and the living donors increased by 7% and 3% respectively. Part of the success is due to the introduction of cyclosporine. The increase in the success rate of kidney transplants has enabled the transplant group to grow rapidly in the group of beneficiaries of the endoscopic nephrotic Medicare program. By the end of 1985, kidney transplantation accounted for 18% of all beneficiaries and 32% of beneficiaries under 55 years of age. In early 1983, in the youngest group, kidney transplants were sufficient to reduce the absolute number of dialysis patients. Because the cost of transplanting patients is only one-third of the cost of dialysis and the quality of life is better, kidney transplants have the best clinical and economic consequences for patients with advanced kidney disease.