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目的 分析680例SARS临床确诊患者的医疗费用及影响因素和典型药物的费用-效果,为临床医生和政府提供决策依据。方法 设计回顾性队列研究,比较重症型和普通型患者在有、无基础疾病间的医疗费用及药品费用差异,分析影响因素。选择三种典型用药,比较其临床有效性和费用-效果。结果 重症型治愈率低于普通型治愈率(73.6％,99.38％,P=0.000);普通型有基础疾病患者治愈率低于无基础病患者(96％,99.66％,P=0.0016),重症型患者治愈率组内无统计学差异。两型患者平均住院日组内比较无统计学差异;有基础疾病和无基础疾病的普通型患者其医疗费用分别为7879.22和7172.23元/人,重症型患者为24912.89和26433.53元/人,组内比较均无统计学差异;患者年龄和病情均与医疗费用相关,y=4585.71+79.04X_1+17188.87X_2;有基础疾病和无基础疾病重症型患者使用中小剂量甲基强的松龙比较,医疗费用和临床效果无统计学差异;使用和不使用病毒唑的普通型无基础疾病患者,其费用-效果比为6107和4225元;使用和不使用胸腺肽的无基础疾病普通型患者费用-效果比分别为11651和6107元。结论 有基础疾病的普通型患者治愈率低于无基础疾病者;费用高低与患者年龄和病情严重程度有关,病情越重,年龄越高,费用越高。药品费用占医疗费用比例最大;中小剂?
OBJECTIVE: To analyze the cost-effectiveness of medical costs, influential factors and typical drugs in 680 cases diagnosed clinically in SARS and to provide decision-making basis for clinicians and government. Methods A retrospective cohort study was designed to compare the differences in medical costs and drug costs between patients with severe and common diseases with or without underlying diseases and to analyze the influencing factors. Choose three typical drugs, compare their clinical effectiveness and cost-effectiveness. Results The cure rate of severe type was lower than that of common type (73.6%, 99.38%, P = 0.000). The cure rate of common type of basic diseases was lower than that of patients without basic diseases (96%, 99.66%, P = 0.0016) Type cure rate group no significant difference. There was no significant difference in the average length of hospitalization between the two types of patients. The common patients with underlying diseases and no underlying diseases were 7879.22 and 7172.23 yuan respectively, while those with severe cases were 24912.89 yuan and 26433.53 yuan / There was no statistical difference between the two groups. The age and condition of the patients were all related to the medical expenses, y = 4585.71 + 79.04X_1 + 17188.87X_2. Compared with the medium-to-low dose methylprednisolone for the patients with severe and non-basic diseases, the medical expenses And the clinical effect was no significant difference; with and without ribavirin in patients with common non-basis disease, the cost-effectiveness ratio of 6107 and 4225 yuan; with and without thymosin-based disease-free patients with common-type cost-effectiveness ratio For 11651 and 6107 yuan. Conclusion The cure rate of the common type of patients with underlying diseases is lower than those without the underlying diseases. The cost is related to the patient’s age and the severity of the illness. The heavier the condition, the higher the age, the higher the cost. Drug costs accounted for the largest proportion of medical expenses; small dose?