摘要
目的分析胶囊内镜检查在小肠出血诊断中的效价,并与传统检查方法进行比较。方法将怀疑小肠出血住院患者分为两组:A组58例,为1998年至2005年间行传统检查患者;B组93例,为2002年5月至2005年1月间行胶囊内镜检查患者。通过统计两组的诊断率、特异性治疗率、检查费用和其他相关累计费用,分析传统检查和胶囊内镜检查的成本效果比及综合成本效果比情况,并进行敏感性检验。结果A组和B组对小肠出血病因的诊断率分别为22.4%(13/58)及86%(80/93),总检查费用分别为133 750元及790 500元。仅从检查成本效果比分析。B组(9881.3元/例)略优于A组(10 288.5元/例)。此外,由于B组的诊断率显著高于A组(P=0.001),而根据诊断结果指导的特异性治疗率B组高于A组(49.5%比12.1%),即B组能更有效终止和节省因病因不能明确而反复就诊、检查、支持治疗和住院等费用。故经调整后的综合成本效果比B组(9881.3元/例)明显优于A组(从1个月的16 361.5元至5年以上的97 424.0元/例),即随着时间的推移,A组比B组每例多花费6480.2～87 542.7元,是B组的1.7～9.9倍。结论对于经胃镜、结肠镜检查阴性而疑有小肠出血的患者,尽早选择胶囊内镜检查比反复进行传统检查更经济实用。
Objective To analyze the cost of capsule endoscopy in diagnosing small bowel bleeding and to compare it with traditional diagnostic methods. Methods The patients suspected with small bowel bleeding were divided into group A（n = 58, collected during 1998 to 2005） diagnosed with traditional processes and group B（n = 93, collected during 2002 to January 2005） diagnosed with capsule endoscopy. The diagnostic yield, specific treatments, examination costs and other accumulated costs of two groups was compared. The examination cost ratio and the integration cost ratio were evaluated. The sensitivity analysis was performed. Results The diagnostic yield of small bowel bleeding in group A and group B were 22. 4% （13/58） and 86% （80/93） , respectively. The total of examination costs were 133 750 RMB and 790 500 RMB, respectively. The examination costs in group B（RMB 9881.3/each） was slightly lower than group A（RMB 10 288.5/each）. Furthermore, as the diagnostic yield of group B was significantly higher than group A（P = 0. 001）. The specific treatments based on the results of the diagnosis was 37.4% higher in group B（49.5%） than group A（12. 1%）. That means the cost of repeated consultations, emergencies room visit, examinations, supporting treatments and hospitalizations in group B were significantly decreased. After the adjustment, the cost in group B（RMB 9881/patient） was lower than group A（16 361.5 RMB in one month-97 424.0 over 5 years/patient ）. The total cost of each patient in group A was 6480.2-87 542.7 RMB more than group B, which represented 1.7-9.9 folds increase. Conclusions The patients who suspected with small bowel bleeding and had a negative results of gastroscopy and colonoscopy were recommended to have capsule endoscopy which yields early diagnosis and less cost.
出处
《中华消化杂志》
CAS
CSCD
北大核心
2007年第6期378-381,共4页
Chinese Journal of Digestion
基金
上海重点学科建设资助项目(Y0205)
关键词
肠疾病
诊断
内镜
成本效果分析
Intestinal disease
Diagnosis Endoscopy
Cost effectiveness and benifit analysis
