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骨关节炎疼痛患者针灸治疗的生活质量和成本效益

Quality of life and cost-effectiveness of acupuncture treatment in patients with osteoarthritis pain.

作者信息

Reinhold Thomas, Witt Claudia M, Jena Susanne, Brinkhaus Benno, Willich Stefan N

机构信息

Institute for Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center, Berlin, Germany.

出版信息

Eur J Health Econ. 2008 Aug;9(3):209-19. doi: 10.1007/s10198-007-0062-5. Epub 2007 Jul 19.

Abstract

To assess quality of life (QoL), costs, and cost-effectiveness of acupuncture treatment plus routine care versus routine care alone in osteoarthritis patients, a randomised, controlled trial was conducted in 255 general practices in Germany. Four hundred and eighty-nine patients with chronic pain due to osteoarthritis of the knee or hip were included to evaluated QoL and costs at baseline and after 3 months using health insurance funds data and standardized questionnaires. Patients receiving acupuncture had an improved QoL associated with significantly higher costs over the 3 months treatment period compared to routine care alone (mean cost-difference: 469.50 euros [95%CI 135.80-803.19 euros]). This increase in costs was primarily due to the costs of acupuncture. The overall ICER was 17,845 euros per QALY gained. The degree of cost-effectiveness was influenced by gender, with female patients achieving a better cost-effectiveness ratio than men. In conclusion, acupuncture was a cost-effective treatment strategy in patients with chronic osteoarthritis pain.

摘要

为评估针刺治疗联合常规护理与单纯常规护理相比,对骨关节炎患者生活质量(QoL)、成本及成本效益的影响,在德国255家全科诊所进行了一项随机对照试验。纳入489例因膝或髋骨关节炎导致慢性疼痛的患者,利用医疗保险基金数据和标准化问卷在基线及3个月后评估生活质量和成本。与单纯常规护理相比,接受针刺治疗的患者在3个月治疗期内生活质量得到改善,但成本显著更高(平均成本差异:469.50欧元[95%CI 135.80 - 803.19欧元])。成本增加主要归因于针刺治疗费用。每获得一个质量调整生命年(QALY)的总体增量成本效果比(ICER)为17,845欧元。成本效益程度受性别影响,女性患者的成本效益比优于男性。总之,针刺是慢性骨关节炎疼痛患者的一种具有成本效益的治疗策略。

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