Beck E J, Kupek E J, Petrou S, Wadsworth J, Miller D L, Pinching A J, Harris J A
Academic Department of Public Health, St Mary's Hospital and Medical School, London, UK.
Int J STD AIDS. 1996 Nov-Dec;7(7):507-12. doi: 10.1258/0956462961918428.
The aim of this study was to evaluate the survival patterns and use and cost of hospital services of AIDS patients treated with azidothymidine (AZT) at St Mary's Hospital, London. A retrospective analysis of inpatient and outpatient case notes was performed, as was a survey of HIV-related care costs in 37 clinical departments. Of the 183 AIDS patients managed between 1 January 1987 and 30 September 1989, 132 were treated with AZt and 51 without AZT. Mean age at time of AIDS diagnosis for these predominantly homosexual men was 37.5 years for those treated with AZT compared with 40.7 years for those not on AZT. Median survival time from date of AIDS diagnosis was significantly longer for patients treated with AZT compared with those not treated with AZT (23 vs 13.5 months, P = 0.0004). The interval from diagnosis of HIV infection to date of AIDS diagnosis did not differ significantly between groups. Inpatients and outpatients use of services was greater for those receiving AZT than for those who did not. Costs reflected this increase use of services and the costs for those treated with AZT were pounds 3061 per AIDS patient-year higher compared with AIDS patients not receiving AZT; 36% of this cost was directly attributable to the cost of AZT itself. The introduction of AZT into routine clinical practice seems to have been a cost-effective intervention though it has been associated with an increased use of hospital services and associated costs per AIDS patient-year as well as increases survival time from AIDS diagnosis.
本研究的目的是评估伦敦圣玛丽医院接受齐多夫定（AZT）治疗的艾滋病患者的生存模式、医院服务的使用情况及费用。对住院和门诊病历进行了回顾性分析，并对37个临床科室的艾滋病相关护理费用进行了调查。在1987年1月1日至1989年9月30日期间管理的183例艾滋病患者中，132例接受了AZT治疗，51例未接受AZT治疗。这些以同性恋男性为主的患者，接受AZT治疗者在艾滋病诊断时的平均年龄为37.5岁，未接受AZT治疗者为40.7岁。与未接受AZT治疗的患者相比，接受AZT治疗的患者从艾滋病诊断日期起的中位生存时间显著更长（23个月对13.5个月，P = 0.0004）。两组从HIV感染诊断到艾滋病诊断的间隔时间无显著差异。接受AZT治疗的住院患者和门诊患者对服务的使用比未接受治疗者更多。费用反映了服务使用的增加，接受AZT治疗的患者每年每例艾滋病患者的费用比未接受AZT治疗的艾滋病患者高3061英镑；其中36%的费用直接归因于AZT本身的费用。将AZT引入常规临床实践似乎是一种具有成本效益的干预措施，尽管它与医院服务使用增加、每例艾滋病患者每年的相关费用增加以及艾滋病诊断后的生存时间延长有关。
