三级护理医院肾内科糖尿病肾病患者的药物经济学评价

Pharmacoeconomic evaluation of diabetic nephropathic patients attending nephrology department in a tertiary care hospital.

作者信息

Jose J V, Jose M, Devi P, Satish R

机构信息

Department of Pharmacology, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India.

Department of Pharmacology, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India.

出版信息

J Postgrad Med. 2017 Jan-Mar;63(1):24-28. doi: 10.4103/0022-3859.194199.

DOI:10.4103/0022-3859.194199

PMID:27853039

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5394813/

Abstract

AIMS

To evaluate the cost of pharmacotherapy and its determinants in diabetic nephropathy (DN) in the nephrology department of a tertiary care hospital.

MATERIALS AND METHODS

A prospective observational study was conducted among adult patients visiting nephrology outpatient department (February-July 2015). Data on demography, investigations, and medications prescribed, direct cost and indirect costs were analyzed. We used Chi-squared test for categorical variables and multivariate linear regression analysis to identify determinants of cost of pharmacotherapy and total cost.

RESULTS

Of 100 patients, 50 were above 60 years and 75 were male. Ninety-seven patients had hypertension, which was the most common comorbidity. The majority (60 patients) belonged to Stage 5 DN and 59 patients were on dialysis. The mean number of drugs per patient was 7.60 ± 2.44. The total monthly cost per patient amounted to INR 24,203.27 with total direct cost of INR 21,013.90 (87%) and indirect cost of INR 3189.30 (13%). The monthly cost of dialysis and pharmacotherapy per patient were INR 9060.00 (37%) and INR 2535.98 (11%), respectively. Stage of DN (unstandardized coefficient, B = 7553.96, 95% confidence interval [CI] [6175.09-8932.82], P < 0.001) was a significant determinant of total cost. Number of drugs (B = 636.694, 95% CI [335.670-937.718], P < 0.001) and stage of DN (B = 852.986, 95% CI [297.043-1408.928], P = 0.003) were predictors of cost of pharmacotherapy.

CONCLUSION

Stage of DN and number of drugs prescribed were major determinants of cost of pharmacotherapy.

摘要

目的

评估一家三级护理医院肾内科糖尿病肾病（DN）患者药物治疗的成本及其决定因素。

材料与方法

对2015年2月至7月期间到肾内科门诊就诊的成年患者进行前瞻性观察研究。分析人口统计学、检查、所开药物、直接成本和间接成本的数据。我们对分类变量使用卡方检验，并采用多元线性回归分析来确定药物治疗成本和总成本的决定因素。

结果

100例患者中，50例年龄在60岁以上，75例为男性。97例患者患有高血压，这是最常见的合并症。大多数（60例）患者属于5期DN，59例患者接受透析治疗。每位患者的平均用药数量为7.60±2.44种。每位患者每月的总成本为24,203.27印度卢比，其中直接成本总计21,013.90印度卢比（87%），间接成本为3189.30印度卢比（13%）。每位患者每月的透析成本和药物治疗成本分别为9060.00印度卢比（37%）和2535.98印度卢比（11%）。DN分期（非标准化系数，B = 7553.96，95%置信区间[CI][6175.09 - 8932.82]，P < 0.001）是总成本的一个重要决定因素。用药数量（B = 636.694，95% CI[335.670 - 937.718]，P < 0.001）和DN分期（B = 852.986，95% CI[297.043 - 1408.928]，P = 0.003）是药物治疗成本的预测因素。