微生态制剂防治婴幼儿肺炎继发腹泻的卫生经济学评价

目的 评价预防性应用微生态制剂(培菲康)防治婴幼儿肺炎继发腹泻的疗效及成本效益.方法 2008年1月到2010年9月住院治疗的婴幼儿肺炎966例为研究对象,对患儿的临床特征、微生态制剂(培菲康)预防性应用情况、是否出现继发腹泻及住院治疗费用的关系进行分析.结果 干预组594例,对照组372例,两组住院治疗期间继发腹泻的发病率分别为18.69％、39.78％,两组比较,x2 =51.889,P ＜0.01,RR=0.470;干预组99例发生继发腹泻后继续原有微生态制剂治疗,对照组134例因继发腹泻才开始应用同类微生态制剂治疗,两组腹泻治疗总有效率分别86.87％、74.63％,差异无统计学意义(x2=5.299,P=O.021).干预组、对照组每例(次)患儿住院总费用分别为(2775.0±1724.2)元和(3130.7±1899.8)元,预防性应用微生态制剂(培菲康)次均节省直接医疗费用支出355.6元,差异有统计学意义(t =2.998,P=0.003)；预防性应用微生态制剂(培菲康)的效益成本比为13.02.结论 预防性应用微生态制剂(培菲康)不仅能降低肺炎继发腹泻的发病率,缩短住院病程,提高腹泻治疗总有效率,同时,明显降低患儿的次均医疗费用,效益成本比高.

Economics evaluation on probiotics in prevention of diarrhea of infants with pneumonia

Objective To evaluate the efficacy and economic benefits of preventive application of probiotics for secondary diarrhea in infants with pneumonia.Methods 966 infants with pneumonia in our hospital were reviewed from Jan.2008 to Sep.2010.The relationships among the clinical features of infants with pneumonia,the prophylactic use of Bifico and the occurrence of secondary diarrhea were analyzed.The economical difference between the prevention group and the control group was analyzed to assess the economic benefits brought by prophylactic probiotics on diarrhea of infants with pneumonia.ResultsThe diarrhea morbidity was 18.69%(111/594) in the intervention group with prophylactic use of Bifico,and 39.78%(148/372) in the control group without Bifico.There were 233 diarrhea cases that were given Bifico during the same period,including 99 cases in the intervention group and 134 in the control group.The total effective rates of the two groups were 86.87%(86/99) and 74.63%(100/134) respectively(χ2=5.299,P=0.021).The medical costs of intervention group and control group were(2775.0±1724.2) yuan and(3130.7±1899.8) yuan per patient,respectively.Prophylactic use of probiotics Bifico saved 355.6 yuan for each patient directly(t=2.998,P=0.003).Its benefit-cost ratio was 13.02.Conclusion Prophylactic Bifico can reduce the incidence of diarrhea secondary to pneumonia,shorten the hospitalization course and improve the efficiency of diarrhea treatment,while significantly shorten the course of the secondary diarrhea.Thus it can reduce medical costs significantly and has high benefit-cost ratio.