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[肺结核新发病例和耐多药病例的治疗成本]

[The cost of treatment in new case and multidrug resistant case in pulmonary tuberculosis].

作者信息

Kizkin Ozkan, Hacievliyagil Süleyman S, Türker Gamze, Günen Hakan

机构信息

Inönü University Faculty of Medicine, Pulmonary Diseases, 44069 Malatya, Turkey.

出版信息

Tuberk Toraks. 2003;51(4):410-5.

Abstract

The treatment of multidrug-resistant pulmonary tuberculosis (MDR-Tbc) is quite difficult, and the disease has high morbidity and mortality rates. This study was designed to compare the costs of treatment in new tuberculosis (new-Tbc) cases and MDR-Tbc cases. Data base of the study was composed of the data from therapy principles of new-Tbc cases and MDR-Tbc, and official directives and price lists of Turkish Pharmacology Society in 2001 fiscal year regulating treatment costs. For new-Tbc cases, the treatment cost included expanses for 20 days of hospitalisation, one month work loss and six months drug supply and laboratory costs; for MDR-Tbc cases, it was comprised by expenses for seven months hospitalisation in average, 12 months work loss, 24 months drug supply and laboratory costs, and probable surgical interventions and post-operative intensive care. The service of hospital stuff and medical equipment provided was disregarded. The cost analyses was calculated as charge price of American dollars ($) dated 14.09.2001. It was found that the cost of therapy for new-Tbc cases and MDR-Tbc cases were 1134.89 $ and 17529.15 $, respectively. In MDR-Tbc cases, the costs of hospitalisation, work loss, drug therapy and laboratory procedures were 10.5, 12, 98.7 and 5.3 times higher respectively, when compared with those of new-Tbc. The cost of thoracotomy for one patient including the cost for 10 days period of post-operative care in intensive care unit was 391.93 $. The treatment of MDR-Tbc has a high cost, and 16 new-Tbc cases can be treated with the same cost in our country. In conclusion, we think that successful treatment strategies for both new-Tbc cases and MDR-Tbc cases will lower the cost of tuberculosis treatment.

摘要

耐多药肺结核(MDR-Tbc)的治疗相当困难,且该病的发病率和死亡率都很高。本研究旨在比较新发性肺结核(new-Tbc)病例和耐多药肺结核病例的治疗成本。该研究的数据库由新发性肺结核病例和耐多药肺结核的治疗原则数据,以及2001财政年度土耳其药理学会规范治疗成本的官方指令和价格表组成。对于新发性肺结核病例,治疗成本包括20天住院费用、一个月的误工损失、六个月的药品供应和实验室费用;对于耐多药肺结核病例,其成本平均包括七个月的住院费用、12个月的误工损失、24个月的药品供应和实验室费用,以及可能的手术干预和术后重症监护费用。医院工作人员服务和提供的医疗设备未予考虑。成本分析以2001年9月14日的美元标价计算。结果发现,新发性肺结核病例和耐多药肺结核病例的治疗成本分别为1134.89美元和17529.15美元。与新发性肺结核病例相比,耐多药肺结核病例的住院、误工、药物治疗和实验室检查成本分别高出10.5倍、12倍、98.7倍和5.3倍。一名患者的开胸手术成本,包括在重症监护病房术后护理10天的费用为391.93美元。耐多药肺结核的治疗成本很高,在我国,同样的成本可以治疗16例新发性肺结核病例。总之,我们认为新发性肺结核病例和耐多药肺结核病例的成功治疗策略都将降低结核病的治疗成本。

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