疑难性腹部疾病的费用效果分析.docVIP

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疑难性腹部疾病诊断的费用效果分析

摘要

目的研究腹腔镜检查在诊断疑难性腹部疾病中的效率（即费用--效果）。

方法将31例疑难性腹部疾病的诊断方法分四组：基础组，腹腔穿刺腹水检查和B超检查；增强CT组，增强CT检查；腹腔镜组，腹腔镜检查；联合组，以上方法联合检查。统计各组的确诊率；以云南省三级甲等医院收费标准，计算各组每确诊1例所需要的平均费用；与基础组相比后三组每增加1例确诊所需要增加的费用；并作敏感性分析。

结果基础组、增强CT组、腹腔镜组和联合组的确诊率分别为2/31、6/31、30/31和30/31；每确诊1例平均费用分别为3348.90元、4511.43元、1455.49元、2124.14元；与基础组相比，每增加1例确诊，后三组所需要增加的费用分别为5092.70元、1320.25元、2036.65元。可见，腹腔镜组和联合组明显优于增强CT组，而且以腹腔镜组为最优。敏感性分析仍然支持本研究结果。

结论疑难性腹部疾病进行腹腔镜检查可尽早明确诊断、及时治疗，其成本费用最少。

关键词:腹腔镜检查腹腔穿刺检查影像学检查疑难病费用效果分析

中国图书分类号:573.2

Acost-effectivenessstudyofdiagnosisbylaparascopy

ofdifficultandcomplicatedabdominaldiseases

ZhouzengfenLushuanQinxingluCuirongDepartmentofGastroenterolong，theFirstAffiliaHospitalofKunmingMedicalCollege，Kunming，650032

ChenshiyaoWangjiyaoDepartmentofGastroenterolong，zhongshanHospital，ShanghaiMedicalUniversity，Shanghai200032

AbstractAimToassessthecost-effectivenessofdiagnosisbylaparascopyofdifficultandcomplicatedabdominaldiseases.MethodsThediagnosticmethodsofthe31casesofdifficultandcomplicatedabdominaldiseasesweredividedintofourgroups:abasicgroup（namely,repeatedascitestestsafterpunctureandultrasonography），aenhancedCTgroup，alaparatorygroupandaalliancegroupoftheabovementionedthreegroups．Thediagnosticrates,theaveragecostsperonecasewhichwascorrectlydiagnosedintheabovefourgroups,andhavingcomparedwiththebasedgroup,theincreasedcostsinthelatterthreegroupswhileaddedonecasewasdiagnosedcorrectlywerecalculatedrespectively..ThecostswerecalculatedaccordingtothestandardofⅢAgradehospitalsintheprovinceofYunnan.Sensitivityanalysisofthefourgroupswasmade,too.ResultsThediagnosticrateswere2/31,6/31,30/31and30/31;theaveragecostswere￥3348.90,￥4511.43,￥1455.49,and￥2124.12inthefourgroupsrespectively;havingcomparedwiththebasicgroup,