Charles E D, Wayne J B, Oberman A, Reed B A, Haynie C, Kouchoukos N T, Rogers W J, Russell R O
Circulation. 1982 Nov;66(5 Pt 2):III87-90.
Direct and indirect costs of medical and of surgical treatment are presented for patients entered into the Birmingham portion of the Coronary Artery Surgery Study. For comparison, similar results are shown for the Birmingham portion of the national Cooperative Unstable Angina Study. In the Unstable Angina Study, mean inpatient costs at the end of 1 year in the study were $6867 for medical therapy, $10,574 for surgical therapy and $23,045 for those who failed medical therapy and required late surgery. A stepwise multiple regression analysis shows that the single best predictor of cost was the number of myocardial infarctions that the patient had while in the study. A discriminant-function analysis identified 85% of the medical patients who required late surgery. A significantly lower proportion of surgical than medical patients returned to work. Total inpatient costs for patients in the Coronary Artery Surgery Study (i.e, patients with stable angina) were $3432, $11,100 and $13,554 for medical, surgical and late surgical patients, respectively, for the first year in the study. There was no significant difference in the percentage of medical and surgical patients who were working at the end of 1 year. According to their own perceptions, the surgical group was in the best and the late surgical group in the worst health.
本文呈现了冠状动脉手术研究中伯明翰地区患者的内科及外科治疗的直接和间接成本。作为对比，还展示了全国不稳定型心绞痛合作研究中伯明翰地区的类似结果。在不稳定型心绞痛研究中，研究结束时内科治疗患者的平均住院费用为6867美元，外科治疗患者为10574美元，内科治疗失败且需后期手术的患者为23045美元。逐步多元回归分析表明，成本的最佳单一预测指标是患者在研究期间发生心肌梗死的次数。判别函数分析识别出了85%需要后期手术的内科患者。与内科患者相比，返回工作岗位的外科患者比例显著更低。冠状动脉手术研究（即稳定型心绞痛患者）中患者第一年的住院总费用，内科、外科及后期外科患者分别为3432美元、11100美元和13554美元。在研究结束时仍在工作的内科和外科患者比例没有显著差异。根据他们自己的认知，外科组健康状况最佳，后期外科组最差。
