The Study Based On Cost Effectiveness Analysis On Integrated Chinese And Western Medicines Clinical Pathway For Advanced Colorectal Cancer

Objective:To evaluate the impact of the integrated traditional Chinese and western medicine clinical pathway used for advanced colorectal cancer treatment on the work efficiency of hospital operation management and its cost effectiveness analysis, and therefore providing references for the State Administration of Traditional Chinese Medicine to make decisions on choosing high quality clinical pathway.Methods:Using the different time comparison trials method, the trial group consists of the eligible patients and those who used clinical pathway in2010or2011. The control group consists of patients who are eligible but didn’t use clinical pathway in2009;Reviewing all the materials and collecting patients’relative hospitalization information including the expenses composition, length of stay, treatment content and the therapeutic effect; Statistically analyzing the expenses, length of stay and the proportion of drug expenses to medical expenses in order to compare the results of two groups, and to evaluate the level of significance of health economics by analyzing its cost effectiveness.Results:The work efficiency and economic operation management:The trial group’s length of stay is18.0±8.58days, and the control group is21.6±11.41days (P<0.05);The trial group’s proprietary Chinese medicine cost is5957.7±4012.2yuan, and4272.3±3514.7yuan(P<0.05) for the control group; The trial group’s Chinese herbal medicine cost is1010.3±618.0yuan, and505.2±327.7yuan(P<0.05) for the control group;The trial group’s medical expense is6310.3±7200.8yuan, and it is10202.0±7491.7yuan(P<0.05)) for the control group; The trial group’s the proportion of drug expenses to medical expenses is3.49±3.87, and it is1.37±0.93(P<0.05) for the control group; The trial group’s the proportion of Chinese medicine expenses of drug expenses is0.57±0.27, and it is0.49±0.27(P<0.05) for the control group. There are no significant difference between the two group’s total hospitalization expenses, average daily hospitalization cost, drug expense, western medicine expense, test cost, radiation cost within the statistical analysis, but only shows trend in reducing the cost. Effectiveness Analysis:The trial group’s primary symptom CBR is98%, it is79.5%(P<0.05) for the control group. As to the CBR of KPS score, RECIST and weight, there is no significant difference between the two groups. Cost effectiveness analysis:the trial group’s C/E value is23189.1and the control group is26553.4. The trial group’s C/E value is lower than the control group, and the same conclusion is made after the sensitivity test.Conclusion:The application of "integrated traditional Chinese and western medicine clinical pathway for advanced colorectal cancer" for hospital medical management is more advantaged in the concept of health economics. Patients will be able to get the same, even better, therapeutic effect with lower costs. Clinical pathway also has traditional Chinese medicine play an more important role in cancer treatment.