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目的了解目前北京大型三级甲等医院小儿癫中心就诊的癫患者治疗相关成本情况,以期为医疗卫生政策的制订以及有限医疗资源的合理配置提供重要依据。方法研究对象为2010年4月-2011年1月于北京大学第一医院小儿神经科门诊就诊的癫患者,所有癫患者治疗至少1 a以上。填写调查问卷,内容包括:患者基本信息、疾病相关信息、治疗相关信息及治疗相关成本。问卷内容所涉及的癫发作频率和治疗相关成本等针对1 a以来的情况进行回顾性调查。在治疗成本的相关因素分析中,分别对因变量[直接成本、抗癫药物(AEDs)费用、交通费和检查费]进行相关因素分析(自变量包括:年龄、体质量、地区、1 a以来有无癫发作、病程、AEDs种数、是否使用新型AEDs)。结果 209例患者1 a的治疗相关的总成本中位数为7 336元(660～88 808元),其中直接成本中位数为6 680元(400～86 728元),间接成本中位数364元(0～3 640元)。总成本构成比(以中位数表示):直接成本占94.59%(50.85%～100.00%),间接成本占5.41%(0～49.15%)。直接成本的构成中AEDs费用、检查费和交通费是主要组成部分。1 a以来有无发作、是否服用新型AEDs、居住地区、年龄、病程从不同方面对于直接成本产生影响。结论本研究是针对国内癫患者治疗成本的首次较大样本的研究。从一个侧面反映出我国癫患者的治疗成本非常昂贵,占人均国民生产总值的28.68%。政府部门亟待制定政策,降低患者家庭的治疗成本。
Objective To understand the cost of treatment of epilepsy patients in pediatric epilepsy center in Beijing large-scale third-class Hospitals at present, in order to provide an important basis for the formulation of medical and health policies and the rational allocation of limited medical resources. Methods The subjects were epileptic patients from April 2010 to January 2011 in pediatric neurology clinic of Peking University First Hospital. All patients with epilepsy were treated for at least 1 year. Fill in the questionnaire, including: basic patient information, disease-related information, treatment-related information and treatment-related costs. Questionnaire content related to the frequency of seizures and treatment-related costs for the 1 a since the retrospective investigation. In the analysis of the related factors of the treatment costs, relevant variables (dependent variables: age, body weight, region, 1 a, year) were analyzed respectively for the dependent variables [direct costs, AEDs expenses, transportation expenses and examination fees] Since the onset of epilepsy, duration, the number of AEDs, whether to use the new AEDs). Results The median total cost of treatment-related costs for the 1 year of 209 patients was 7 336 yuan (660-88 808 yuan), of which the direct cost median was 6 680 yuan (400-86 728 yuan). The median indirect cost 364 yuan (0 ~ 3 640 yuan). The total cost ratio (in median): direct costs accounted for 94.59% (50.85% ~ 100.00%), indirect costs accounted for 5.41% (0 ~ 49.15%). The composition of direct costs AEDs costs, inspection fees and transportation costs are the main components. 1 a since the onset, whether to take new AEDs, living area, age, duration of the direct costs from different aspects have an impact. Conclusion This study is the first large-scale study of treatment costs for patients with epilepsy in the country. From one side of the reflection of the treatment of epilepsy patients in our country is very expensive, accounting for 28.68% of the GNP per capita. Government departments urgently need to formulate policies to reduce the treatment costs for patients’ families.