重型肝炎患者健康生命质量及成本效用分析

发布时间：2018-05-28 05:04

本文选题：重型肝炎 + 肝衰竭　；参考：《天津大学》2014年硕士论文

【摘要】：研究目的：本研究通过选用一般情况调查表、SF-36医学简明量表、社会支持评定量表、自评抑郁量表和成本收集表，了解重型肝炎患者生命质量现状、影响因素和保守治疗的成本-效用情况，为重型肝炎患者生命质量的干预和治疗的选择提供依据。研究方法：①通过文献研究法，了解和把握当今国内外重型肝炎患者生命质量及药物经济学的研究现状和最新的研究进展。②在文献研究的基础上，选用一般情况调查表和SF-36医学简明量表、社会支持评定量表、自评抑郁量表对2012年1月到2013年8月期间在上海市四所三级医院住院的312例重型肝炎患者进行生命质量调查和影响因素的分析。③通过SF-36医学简明量表及自行编制的成本收集表对2012年3月到2013年6月上海市四所三级医院被诊断为重型肝炎的出院患者284例进行调查，计算患者的总成本、总效用及成本-效用比情况。研究结果：①本研究通过对重型肝炎患者生命质量的数据分析显示，其生命质量得分低于正常人，与常模比较有统计学意义(p＜0.05)，提示重型肝炎患者的生活质量较差。②通过单因素分析研究对象社会人口学信息对PCS、MCS得分的影响，结果发现年龄、有无保险、保险类型、并发症的数量、疾病分型等对两者总分的影响有统计学意义(p＜0.05)，是否抗病毒治疗仅对PCS总分的影响有统计学意义(p＜0.05)；而性别、月收入、居住地等对两者的影响均无统计学意义。③逐步多元线性回归分析显示年龄、并发症数量是影响PCS得分的主要影响因素(p＜0.05)，，且与其呈负相关；并发症数量以及有无保险是影响MCS得分的主要影响因素(p＜0.05)，且与其呈负相关。相关性分析结果显示，重型肝炎患者的社会支持水平与PCS、MCS得分呈正相关，抑郁水平与PCS、MCS得分呈负相关。④通过对重型肝炎患者成本及效用的计算，结果显示：重型肝炎患者的总成本为（42806.67±3896.45）元，总效用为1.33，成本-效用比为元32185.47元/QALYs。研究结论：重型肝炎患者的生命质量与正常人群相比较为低下，我们应该积极对该人群的生命质量实施干预，在干预的过程中要考虑年龄、有无保险、并发症数量、社会支持等因素对患者造成的影响，开展有针对性的干预方案；另外，重型肝炎保守治疗的成本较高，尤其是药物的费用，需卫生政府部门予以积极的关注和合理的调配。
[Abstract]:Objective: to investigate the quality of life of patients with severe hepatitis by selecting SF-36 medical brief scale, social support rating scale, self-rating depression scale and cost collection table. The influencing factors and the cost-effectiveness of conservative treatment provide basis for the intervention of quality of life and the choice of treatment in patients with severe hepatitis. Research methods: 1 through literature research, we understand and grasp the current research situation of quality of life and pharmacoeconomics of patients with severe hepatitis both at home and abroad and the latest research progress .2 on the basis of literature research, General situation questionnaire and SF-36 Medical brief scale, Social support rating scale, Investigation of quality of Life and influencing factors of 312 patients with severe Hepatitis hospitalized in four Grade III Hospitals in Shanghai from January 2012 to August 2013 From March 2012 to June 2013, 284 discharged patients diagnosed as severe hepatitis in four tertiary hospitals in Shanghai were investigated. Calculate the patient's total cost, total utility and cost-utility ratio. Results: 1 in this study, the quality of life score of patients with severe hepatitis was lower than that of normal people, according to the analysis of data on the quality of life of patients with severe hepatitis. Compared with the norm, there was significant difference (p < 0.05), which suggested that the quality of life of the patients with severe hepatitis was poor. 2 the effect of social demographic information on the MCS score of the patients with severe hepatitis was studied by univariate analysis. The results showed that age, insurance and type of insurance were found. The number of complications and the type of disease had significant effects on the total score of the two groups (p < 0.05). Whether the effect of antiviral therapy only on the total score of PCS was statistically significant (P < 0.05), but gender, monthly income, No stepwise linear regression analysis showed that the effect of residence and other factors on both was not statistically significant. The number of complications was the main influencing factor of PCS score (p < 0.05), and was negatively correlated with it. The number of complications and the availability of insurance were the main influencing factors of MCS score (P < 0.05), and were negatively correlated with them. The results of correlation analysis showed that the level of social support in patients with severe hepatitis was positively correlated with the score of MCS in patients with severe hepatitis, and the level of depression was negatively correlated with the score of MCS of patients with severe hepatitis by calculating the cost and effectiveness of the patients with severe hepatitis. The results showed that the total cost of severe hepatitis patients was 42806.67 卤3896.45 yuan, the total utility was 1.33, and the cost-utility ratio was 32185.47 yuan / QALYS. Conclusion: the quality of life of the patients with severe hepatitis is lower than that of the normal population. We should actively intervene in the quality of life of this group. In the process of intervention, we should consider age, insurance or not, and the number of complications. In addition, the cost of conservative treatment of severe hepatitis is high, especially the cost of drugs, which needs the active attention and reasonable allocation of health departments.
【学位授予单位】：天津大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R575.1

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