Borrell M, Méndez M A, Gros T, de la Figuera M, Davins J, del Amo M, Casas A, Espel C, Ciurana R
Area Básica de Salud La Mina, Sant Adrià de Besòs, Barcelona.
Aten Primaria. 1994 Oct 15;14(6):829-34.
To analyse the number of attendances and the direct cost of pharmaceutical prescription arising from a year-long monitoring of hypertense patients.
Health Centre.
A prospective observation study.
220 hypertense patients, undergoing arterial pressure (AP) monitoring, were chosen by means of systematic random sampling.
The variables of age, gender, cardiovascular risk factors, AP, monitoring level (criterion AP < 160-90 mmHg), attendances and treatment used were analysed. The pharmaceutical cost was calculated in line with the dosages and according to the 1990 Vademecum. The monitoring level was 43.6%. The total number of attendances per patient were 12.8 +/- 6.43 and those for hypertension, 7.9 +/- 3.5. Diabetics attended more for hypertension (8.8 vs 7.5, p < 0.05). Pharmaceutical treatment was prescribed for 183 people (83.2%). The number of drugs was correlated with the severity of the hypertension and the number of attendances. Overall drug cost was 429,571 pesetas per month. Average monthly cost per patient was 2,348.69 +/- 2,318.92 pesetas (range 90.5-12,856.5). Angiotensin enzyme conversion inhibitors (AECI) made for the greatest monthly mean cost per patient (4,352.9 pesetas) and diuretics, the least (322.2 pesetas).
Frequency of attendance is related to the presence of diabetes and the number of drugs prescribed. The introduction of AECI and Calcium antagonists into first-line treatment represents an important increase in the cost of controlling Hypertension.
分析对高血压患者进行为期一年的监测所产生的就诊次数及药物处方直接费用。
健康中心。
前瞻性观察研究。
通过系统随机抽样选取220例接受动脉压（AP）监测的高血压患者。
分析了年龄、性别、心血管危险因素、动脉压、监测水平（标准为AP < 160 - 90 mmHg）、就诊次数及所用治疗方法等变量。根据剂量并参照1990年《用药指南》计算药物费用。监测水平为43.6%。每位患者的就诊总次数为12.8 ± 6.43次，高血压就诊次数为7.9 ± 3.5次。糖尿病患者因高血压就诊次数更多（8.8次对7.5次，p < 0.05）。183人（83.2%）接受了药物治疗。药物数量与高血压严重程度及就诊次数相关。每月药物总费用为429,571比塞塔。每位患者每月平均费用为2,348.69 ± 2,318.92比塞塔（范围90.5 - 12,856.5比塞塔）。血管紧张素酶转换抑制剂（AECI）每位患者每月平均费用最高（4,352.9比塞塔），利尿剂最低（322.2比塞塔）。
就诊频率与糖尿病的存在及所开药物数量有关。将AECI和钙拮抗剂引入一线治疗意味着控制高血压的费用大幅增加。
