Cost-Effectiveness Analysis of Combined Chinese Medicine and Western Medicine for Ischemic Stroke Patients

• Published in: Chinese journal of integrative medicine Vol. 20; no. 8; pp. 570 - 584
• Main Author: 李毅 席韩旭 朱莎 于娜 王静 李岩 俞国培 马谢民 张俊 赵乐平
• Format: Journal Article
• Language: English
• Published: Heidelberg Chinese Association of Traditional and Western Medicine 01.08.2014
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Brain Ischemia - complications; Brain Ischemia - drug therapy; Brain Ischemia - economics; Child; Child, Preschool; Cost-Benefit Analysis; CPS; Decision Trees; Drug Therapy, Combination; Female; Hospitalization - economics; Humans; Infant; Infant, Newborn; Length of Stay; Linear Models; Male; Medicine; Medicine & Public Health; Medicine, Chinese Traditional - economics; Middle Aged; Original Article; Patents as Topic; Risk Factors; Stroke - complications; Stroke - drug therapy; Stroke - economics; Treatment Outcome; Young Adult; 中国医药; 总结报告; 患者; 成本效益分析; 缺血; 西医; 郊野公园; Chinese medicine; cost-effectiveness analysis; Western medicine; ischemic stroke
• ISSN: 1672-0415; 1993-0402; 1993-0402
• DOI: 10.1007/s11655-014-1759-9

Objective： To evaluate the cost-effectiveness of combining Chinese medicine （CM） with Western medicine （WM） for ischemic stroke patients. Methods： Hospitalization summary reports between 2006 and 2010 from eight hospitals in Beijing were used to analyze the length of stay （LOS）, cost per stay （CPS）, and outcomes at discharge. Results： Among 12,009 patients （female, 36.44%; mean age, 69.98 ＋ 13.06 years old）, a substantial number of patients were treated by the WM_Chinese patent medicine （CPM）_Chinese herbal medicine （CHM） （38.90%）; followed by the WM_CPM （32.55%）, the WM （24.26%）, and the WM_CHM （4.15%）. With adjustment for confounding variables, LOS of the WM_CPM_CHM group was about 10 days longer than that of the WM group, and about 6 days longer than that of the WM_CPM group or the WM_CHM group （P〈0.01）; CPS of the WM_CPM_CHM group was United States dollar （USD） 1,288 more than that of the WM group, and about USD 600 more than that of the WM_CPM group or the WM_CHM group （P〈0.01）. Compared with the WM group, odd ratio （OR） of recovered and improved outcome of the WM_CPM CHM group was the highest [OR： 12.76, 95% confidence intervals （CI）： 9.23, 17.64, P〈0.01], OR of death outcome of the WM_CPM_CHM group was the lowest （OR： 0.08, 95% CI： 0.05, 0.12, P〈0.01）. There was no significant difference between LOS, CPS and OR of the WM_CPM group and those of the WM_CHM group （P〉0.05）. Cost/effectiveness and incremental cost- effectiveness ratio of the WM_CPM_CHM group were robustly higher than those of the WM group. Conclusion： Compared with WM alone, supplementing CPM and CHM to WM provides significant health benefits of improving the chance of recovered and improved outcome, and reducing the death rate, at an expense of longer LOS and higher CPS.