The Cost-effectiveness Evaluation Of Cystic Hepatic Hydatid Disease Ope Ration Before And After Standardized Treatment

Objective:Through to the Xinjiang area 9 by the standardized training of division level,and standardized patients with hepatic cyst echinococcosis treated from 2005-2013 in municipal hospital hospitalization expenses and its affecting factors.To understand the status of hospitalization expenses in patients with liver hydatid disease,and discusses its main influencing factor.At the same time,adopt the method of cost-effectiveness evaluation of standardized treatment before and after normalization treatment of hepatic cyst echinococcosis different surgical methods in different periods,different level hospitals of effectiveness and economy of comprehensive evaluation.Methods:In this study,nine hospitalized patients with cystic liver hydatid disease treated with standardized training in Xinjiang from 2005 to 2013 were selected as retrospective survey.At the same time in 2010 as the boundary,divided into pre-specification and normalization.All subjects were followed up for at least 2years,the final collection of 900 cases of effective medical records.The questionnaire information was collected by means of site visits,postoperative B-mode or CT results.Including information on general condition,surgical procedure,hospital grade,postoperative bile leakage,residual cavity infection and cost details.Using SPSS20.0 software for statistical analysis,measurement data using the mean,median and quartile spacing description.For the two groups compared between the use of t test or nonparametric rank test.For the comparison between multiple groups using the analysis of variance or nonparametric rank test.For the count data using χ2 test or Fisher exact probability method.Multivariate regression analysis was used for multivariate analysis.For cost-effectiveness analysis using cost-effectiveness ratio,incremental cost-effectiveness ratio and sensitivity analysis.Results:1.The average cost of hospitalization increased year by year,from 10865.02 yuan in 2005 to22260.77 yuan in 2013,an increase of 1.05 times,the difference was statistically significant(P <0.05).The average hospitalization expense was 13533.15 yuan before standardized treatment,and the standardized treatment was 19680.02 yuan;and standardized treatment before and after the drug fee(38.36%,38.40%)and operation fee based(24.62%,18.99%).2.Before standardized treatment the influence factors of average per capita hospitalization cost was followed by the hospital level,hospitalization days,age and the way of surgery(P < 0.05).Standardized treatment after the influence factors of average per capita hospitalization cost was followed by the hospital level,hospitalization days,age,number of years and cyst(P < 0.05).3.Secondary hospital standardized treatment of the first four operation mode C/E in the order139.16、134.10、158.23、118.69.△C/△E as follows-321.94、245.70、48.99.The result of sensitivity analysis was consistent with the result of cost effect analysis.4.After the treatment of secondary hospital standardized operation method C/E in the order 209.40、182.56、176.10、158.42.△C/△E as follows31.84、91.20、14.21.The result of sensitivity analysis was consistent with the result of cost effect analysis.5.Tertiary hospital standardized treatment of the first four operation mode C/E in the order 371.86、253.44、254.12、218.86.△C/△E as follows-189.70、-187.53、2155.95.The result of sensitivity analysis was consistent with the result of cost effect analysis.6.After the treatment of tertiary hospital standardized operation method C/E in the order 520.59、380.98、305.56、265.39.△C/△E as follows-315.71、-441.17、1257.26.The result of sensitivity analysis was consistent with the result of cost effect analysis.Conclusions :1.Normalized average per capita hospitalization cost before and after treatment in patients with liver echinococcosis in xinjiang with the growth of the year.The length of hospital stay,the growth of the age is increasing year by year,and given priority to with the drug and operation fee.2.Before standardized treatment the influence factors of hospitalization expense per capita is the level of hospital,hospitalization days,age and operation method.Standardized treatment after the influence factors of hospitalization expense per capita is the hospital level,hospitalization days,age,date and number of cysts.3.Outer membrane capsule complete resection is suitable for different levels inside and outside the hospital,the different stages of the effective and economic ideal operation method,worthy of promotion of implementation.