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目的:对临床上常用的两种烧伤治疗方案进行成本–效果分析,旨在找到一种成本较低、疗效较好的治疗方案,在保证患者生存质量较好的基础上,减少医疗资源浪费。方法:从湖南、四川2省8家三级医院抽取1017例烧伤患者作为研究对象。收集研究对象入院时一般情况和病情资料、治疗期间所产生的直接医疗费用和治疗效果,按要求分成研究组(烧伤湿润暴露疗法组)和对照组(切削痂植皮组),进行成本–效果分析。结果:研究组例均成本[93633.71(82260.79,107576.34)元]明显低于对照组例均总成本[175077.93(131433.23,228918.83)元](P<0.05);研究组总有效率(97.28%)高于对照组总有效率(92.89%)(P<0.05);研究组成本/效果(C/E)值(962.52)明显低于对照组C/E值(1884.79),研究组治疗成本低于对照组,但疗效优于对照组。结论:成本–效果分析用于治疗方案的评估具有客观和直观性,对临床治疗方案和医疗保险付费方式的选择具有很好的指导作用;湿润暴露疗法在深Ⅱ°烧伤治疗中具有成本较低、疗效较好的优势。
OBJECTIVE: To carry out the cost-effectiveness analysis of two kinds of burns treatment programs commonly used clinically in order to find a treatment plan with lower cost and better curative effect, and to reduce the waste of medical resources on the basis of better quality of life of patients. Methods: A total of 1017 cases of burn patients from 8 tertiary hospitals in 2 provinces of Hunan Province and Sichuan Province were selected as research subjects. The general medical condition and condition data of the subjects who were admitted to the hospital were collected, and the direct medical expenses and treatment effects during the treatment were collected and divided into the research group (burn wet exposure therapy group) and the control group (cutting excision skin graft group) according to the requirements, and the cost-effectiveness analysis . Results: The average cost per case of the study group [93633.71 (82260.79,107576.34) yuan] was significantly lower than that of the control group [175077.93 (131433.23,228918.83) yuan] (P <0.05). The total effective rate (97.28%) in the study group was high The total effective rate (92.89%) in the control group (P <0.05); the cost / effect (C / E) value of the study group (962.52) was significantly lower than that of the control group (1884.79) Group, but the effect is better than the control group. CONCLUSION: Cost-effectiveness analysis is objective and intuitive in the assessment of treatment regimen, which can guide the selection of clinical treatment plan and medical insurance payment method. The cost of wetting exposure therapy in deep Ⅱ ° burn treatment is lower , The advantages of better efficacy.