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补充锌元素可降低儿童急性腹泻的治疗成本并缩短病程。

Zinc supplementation reduced cost and duration of acute diarrhea in children.

作者信息

Gregorio Germana V, Dans Leonila F, Cordero Cynthia P, Panelo Carlo A

机构信息

Department of Pediatrics, University of the Philippines College of Medicine, Philippine General Hospital, Taft Avenue, Manila, Philippines.

出版信息

J Clin Epidemiol. 2007 Jun;60(6):560-6. doi: 10.1016/j.jclinepi.2006.08.004. Epub 2006 Dec 11.

Abstract

OBJECTIVE

To determine whether zinc with oral rehydration solution (ORS) is more cost effective than ORS alone in the treatment of acute diarrhea.

STUDY DESIGN AND SETTING

Cost-effectiveness analysis among patients consulting the emergency room of a government institution.

METHOD

Cost of treatment and outcome of participants of a randomized trial of zinc+ORS vs. ORS alone for acute diarrhea were investigated. Included were subjects 2-59 months with diarrhea <7 days and no dehydration. The direct medical, nonmedical and indirect costs were obtained, using the societal perspective. The incremental cost-effectiveness ratio (ICER) was calculated.

RESULTS

Sixty patients were given zinc+ORS and 57 were given ORS alone. Mean duration of diarrhea was 17 hours shorter and mean total cost of treatment was 5% cheaper in the zinc than ORS group . The ICER showed that with use of zinc, the society saves $ 2.4 per day of diarrhea <4 days and spends $ 0.03 per case of diarrhea averted <4 days from consult, although the confidence interval included the null value of zero.

CONCLUSION

Use of zinc with ORS reduced the total cost and duration of acute diarrhea. The ICER suggests cost effectiveness of zinc supplementation but there is a need to further assess the role of zinc supplementation in a larger population.

摘要

目的

确定在治疗急性腹泻时,锌与口服补液盐(ORS)联合使用是否比单独使用ORS更具成本效益。

研究设计与地点

在一家政府机构的急诊室就诊患者中进行成本效益分析。

方法

调查了锌+ORS与单独使用ORS治疗急性腹泻的随机试验参与者的治疗成本和结果。纳入对象为年龄2至59个月、腹泻时间<7天且无脱水的患者。从社会角度获取直接医疗成本、非医疗成本和间接成本,并计算增量成本效益比(ICER)。

结果

60例患者接受锌+ORS治疗,57例患者单独接受ORS治疗。锌治疗组的腹泻平均持续时间缩短了17小时,平均总治疗成本比ORS组便宜5%。ICER显示,使用锌时,对于腹泻<4天的情况,社会每天节省2.4美元,每避免一例<4天的腹泻病例花费0.03美元,尽管置信区间包含零值。

结论

锌与ORS联合使用可降低急性腹泻的总成本和持续时间。ICER表明补充锌具有成本效益,但需要在更大规模人群中进一步评估补充锌的作用。

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