临床姑息治疗的成本-效果研究系统综述:基于国际临床随机对照研究证据

发布时间：2018-05-21 20:33

本文选题：姑息治疗 + 临终关怀　；参考：《中国卫生经济》2016年05期

【摘要】：目的:对国际发表的临终患者姑息治疗的临床随机对照研究(randomized controlled trail,RCT)的成本-效果评估文献进行系统综述,为我国支付及临床决策提供姑息疗法成本和成本-效果研究依据。方法:纳入2000年至2015年间国际发表的姑息治疗和常规治疗的RCT研究文献,对姑息治疗临床产出、相关成本及成本-效果研究进行汇总。结果:最终有6项RCT研究纳入本次系统综述分析。结果显示与常规治疗相比,在临终阶段实施姑息治疗不仅可以使患者的临床症状控制平稳、生命质量提高、缓解抑郁情绪、照顾满意度提高,而且患者生存期不会缩短,甚至延长。对临床资源使用情况显示,姑息治疗更少采用激进治疗,因此带来医疗费用的大量节省。结论:对临终期患者实施姑息治疗具有非常好的成本-效果优势,我国积极推动姑息治疗将会带来巨大的临床收益,并提高医疗资源的使用效率。
[Abstract]:Objective: to make a systematic review of the international literature on cost-effectiveness assessment of randomized controlled trailage in palliative treatment of terminal patients, and to provide a basis for the study of palliative therapy cost and cost-effectiveness in China. Methods: from 2000 to 2015, the RCT literature on palliative treatment and conventional therapy were collected, and the clinical output, related cost and cost-effect of palliative therapy were summarized. Results: finally, 6 RCT studies were included in this systematic review analysis. The results showed that palliative treatment in the deathbed stage could not only control the clinical symptoms smoothly, improve the quality of life, relieve depression, improve care satisfaction, but also not shorten the survival time of the patients. Even extended. The use of clinical resources shows that palliative treatment is less aggressive, resulting in significant savings in medical costs. Conclusion: palliative treatment for terminal patients has a very good cost-effect advantage. It will bring great clinical benefits and improve the efficiency of medical resources in China.
【作者单位】：清华大学公共管理学院;湖北省人力资源和社会保障厅医疗保险管理局;清华大学深圳研究生院医院管理研究院;
【分类号】：R48

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