Volume 21 Issue 3
Mar.  2023
Turn off MathJax
Article Contents
Article Navigation >  Chinese Journal of General Practice  > 2023  >  21(3): 423-428
XIN Wenlin, SUN Xiaowei, YU Zexing, LI Li, FAN Enfang, ZHU Xiaoxia, LIU Chunfeng, NI Chunming, TANG Jingdong. Predictive analysis of cost utility of lower extremity artery repair in prevention of diabetes and lower extremity arteriosclerosis obliterans[J]. Chinese Journal of General Practice, 2023, 21(3): 423-428. doi: 10.16766/j.cnki.issn.1674-4152.002899
Citation: XIN Wenlin, SUN Xiaowei, YU Zexing, LI Li, FAN Enfang, ZHU Xiaoxia, LIU Chunfeng, NI Chunming, TANG Jingdong. Predictive analysis of cost utility of lower extremity artery repair in prevention of diabetes and lower extremity arteriosclerosis obliterans[J]. Chinese Journal of General Practice, 2023, 21(3): 423-428. doi: 10.16766/j.cnki.issn.1674-4152.002899
shu

Predictive analysis of cost utility of lower extremity artery repair in prevention of diabetes and lower extremity arteriosclerosis obliterans

doi: 10.16766/j.cnki.issn.1674-4152.002899
  • 1.

    Department of General Medicine, Shanghai Pudong Hospital, Shanghai 200120, China

Funds:

 202150004

  • Received Date: 2022-03-23
    Available Online: 2023-04-19
    Abstract
  •   Objective  To analyse the cost-effectiveness of regular full-course repair of lower extremity arteries in the prevention and treatment of diabetes complicated with lower extremity arteriosclerosis obliterans (ASO), to demonstrate the application value of the full-course repair of lower extremity arteries in the management of diabetes patients in the community.  Methods  Literature research and consultation with Shanghai Pudong Hospital ' s vascular surgery experts were conducted from December 2020 to February 2021. Status classification, transition probability, cost, quality-adjusted life year and other related data of diabetes complicated with lower extremity arterial disease were collected to establish diabetes combined with the Markov model of lower extremity ASO, generate cohort data under conventional treatment and regular full-course repair of lower extremity arteries and compare the cost-effectiveness of treatment costs and quality-adjusted life-year output.  Results  The simulated sample was 1 000 cases under conventional treatment, and 18.5% (185 cases) of patients developed ulcers in the terminal stage, with an amputation rate of 50.3% (503 cases) and a mortality rate of 36.7% (367 cases). Under regular full-course repair of lower limb arteries, the rate of terminal ulcers was less than 10%, the rate of amputation was 1.0%-4.9% and the mortality rate was between 0.7%-3.3%. When the lower extremity arterial repair treatment was performed regularly, the average treatment cost of each diabetic patient in 20 years was 397 476.8-706 237.5 yuan higher than that of conventional treatment, and the incremental cost-utility ratio was 129 087.4-213 034.5 yuan/quality-adjusted life year.  Conclusion  The lowest value of the incremental cost-utility ratio of regular full-course repair of lower extremity arteries is less than the GDP per capita of Shanghai in 2019, and the highest value is less than three times the GDP per capita of Shanghai in 2019, which is worthy of being included in the advanced and appropriate technology for prevention and treatment of diabetes foot in diabetes patients with lower limb ASO in Shanghai.

     

    • FullText(HTML)
  • loading
    • References(23)
  • [1]
    郑月宏, 宋希涛. 下肢动脉硬化闭塞症治疗进展与展望[J]. 中华外科杂志, 2021, 59(12): 961-964. doi: 10.3760/cma.j.cn112139-20210923-00453

    ZHENG Y H, SONG X T. Progress and prospect of the treatment of lower extremity arteriosclerosis obliterans[J]. Chinese Journal of Surgery, 2021, 59(12): 961-964. doi: 10.3760/cma.j.cn112139-20210923-00453
    [2]
    中华医学会糖尿病学分会, 中华医学会感染病学分会, 中华医学会组织修复与再生分会. 中国糖尿病足防治指南(2019版)(Ⅱ)[J]. 中华糖尿病杂志, 2019, 11(3): 161-162, 189. https://www.cnki.com.cn/Article/CJFDTOTAL-HBYX201911002.htm

    Chinese Diabetes Soiety, Chinese Society of Infectious Diseases, Chinese Society for Tissue Repair and Regeneration. Chinese guideline on prevention and management of diabetic foot (2019 edition) (Ⅱ)[J]. Chinese Journal of Diabetes Mellitus, 2019, 11(3): 161-162, 189. https://www.cnki.com.cn/Article/CJFDTOTAL-HBYX201911002.htm
    [3]
    黄彩莲, 张淑琴. 糖尿病下肢动脉硬化闭塞症的外科临床疗效及护理研究[J]. 糖尿病新世界, 2019, 22(15): 145-146. https://www.cnki.com.cn/Article/CJFDTOTAL-TNBX201915086.htm

    HUANG C L, ZHANG S Q. Clinical efficacy and nursing of surgical treatment for diabetic lower extremity arteriosclerosis obliterans[J]. Diabetes New World, 2019, 22(15): 145-146. https://www.cnki.com.cn/Article/CJFDTOTAL-TNBX201915086.htm
    [4]
    王鸿铭, 于翔. 糖尿病合并下肢动脉硬化闭塞症患者介入治疗的护理干预[J]. 双足与保健, 2019, 28(18): 112-113. https://www.cnki.com.cn/Article/CJFDTOTAL-SZBJ201918061.htm

    WANG H M, YU X. Nursing intervention of interventional therapy for patients with diabetes mellitus and lower extremity arteriosclerosis obliterans[J]. Biped and Health, 2019, 28(18): 112-113. https://www.cnki.com.cn/Article/CJFDTOTAL-SZBJ201918061.htm
    [5]
    朱虹, 叶婷婷, 沈飞霞. 从经典病例看糖尿病足分级诊疗的迫切性[J]. 中华糖尿病杂志, 2017, 9(2): 143-144.

    ZHU H, YE T T, SHEN F X. To explore the urgency of hierarchical diagnosis and treatment of diabetic foot from the classic cases[J]. Chinese Journal Of Diabetes Mellitus, 2017, 9(2): 143-144.
    [6]
    王甦平, 马佳莉, 朱伟俊, 等. 社区糖尿病患者分级诊疗依从性影响因素分析[J]. 中华全科医学, 2019, 17(7): 1164-1166, 1221. doi: 10.16766/j.cnki.issn.1674-4152.000891

    WAGN S P, MA J L, ZHU J W, et al. Analysis of factors influencing community diabetic patients on the compliance of tiered medical services[J]. Chinese Journal of General Practice, 2019, 17(7): 1164-1166, 1221. doi: 10.16766/j.cnki.issn.1674-4152.000891
    [7]
    张玉彩, 谢春, 香利强, 等. 紧密型医联体模式下全科医学科建设探索[J]. 中华全科医学, 2019, 17(4): 661-665. doi: 10.16766/j.cnki.issn.1674-4152.000761

    ZHANG Y C, XIE C, XIANG L Q, et al. Exploration of the construction of general medicine department under the close medical association[J]. Chinese Journal of General Practice, 2019, 17(4): 661-665. doi: 10.16766/j.cnki.issn.1674-4152.000761
    [8]
    上海市人民政府新闻办公室. 浦东新区开创全科统筹门诊, 为分级诊疗探索全新途[EB/OL]. (2018-05-10)[2022-01-02]. http://www.shio.gov.cn/sh/xwb/n782/n783/u1ai17028.html.

    Information Office Of Shanghai Municipality. Pudong New Area has created a general practice outpatient clinic, exploring a new way for hierarchical medical system[EB/OL]. (2018-05-10)[2022-01-02]http://www.shio.gov.cn/sh/xwb/n782/n783/u1ai17028.html.
    [9]
    新民晚报. 上海发布首批30个"创新医疗服务品牌"[EB/OL]. (2018-12-27)[2022-01-02]. https://baijiahao.baidu.com/s?id=1620968071183285091&wfr=spider&for=pc.
    [10]
    杨敏杰, 周晟, 孟庆刚. 基于马尔可夫链的中医药疗效预测模型构建与探索[J]. 中华中医药学刊, 2018, 36(7): 1594-1597. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYHS201807016.htm

    YANG M J, ZHOU S, MENG Q G. Construction and exploration of TCM clinical efficacy evaluation based on Markov Model[J]. Chinese Archives of Traditional Chinese Medicine, 2018, 36(7): 1594-1597. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYHS201807016.htm
    [11]
    VASSILIOU P C G, GEORGIOU A C. Markov and Semi-Markov Chains, processes, systems, and emerging related fields[J]. Mathematics, 2021, 9(19): 2490.
    [12]
    李琳琳, 李光新, 王宾. 保守与介入治疗Fontaine Ⅱ期下肢动脉硬化闭塞症患者近期和远期疗效对比[J]. 中华普通外科杂志, 2021, 36(12): 931-935. https://www.cnki.com.cn/Article/CJFDTOTAL-WMIA201856069.htm

    LI L L, LI G X, WANG B. Comparison of short and long term curative effect between conservative and interventional therapy in Fontaine stage Ⅱ patients with lower extremity arteriosclerosis obliterans[J]. Chinese Journal of General Surgery, 2021, 36(12): 931-935. https://www.cnki.com.cn/Article/CJFDTOTAL-WMIA201856069.htm
    [13]
    黄江涛, 王刚. 早期介入治疗下肢动脉硬化闭塞症的疗效及安全性评价[J]. 基层医学论坛, 2019, 23(32): 4727-4728. https://www.cnki.com.cn/Article/CJFDTOTAL-YXLT201932104.htm

    HUANG J T, WANG G. To evaluate the efficacy and safety of early interventional therapy for lower extremity arteriosclerosis obliterans[J]. The Medical Forum, 2019, 23(32): 4727-4728. https://www.cnki.com.cn/Article/CJFDTOTAL-YXLT201932104.htm
    [14]
    谷涌泉, 郭建明. 糖尿病膝下动脉病变腔内治疗的新进展[J]. 中国微创外科杂志, 2017, 17(4): 289-293. https://www.cnki.com.cn/Article/CJFDTOTAL-ZWWK201704001.htm

    GU Y Q, GUO J M. Noval progress of endovascular treatment of diabetic below knee arteries lesions[J]. Chinese Journal of Minimally Invasive Surgery, 2017, 17(4): 289-293. https://www.cnki.com.cn/Article/CJFDTOTAL-ZWWK201704001.htm
    [15]
    NEAL R B, EVERARDO F, MICHAEL B, et al. The accuracy and cost-effectiveness of strategies used to identify peripheral artery disease among patients with diabetic foot ulcers[J]. J Vasc Surg, 2016, 64(6): 1682-1690.
    [16]
    BEAYDET A, CLEGG J, THURESSON P O, et al. Review of utility values for economic modeling in type 2 diabetes[J]. Value Health, 2014, 17(4): 462-470.
    [17]
    中华医学会糖尿病学分会, 中华医学会感染病学分会, 中华医学会组织修复与再生分会. 中国糖尿病足防治指南(2019版)(Ⅰ)[J]. 中华糖尿病杂志, 2019, 11(2): 92-93, 108. https://www.cnki.com.cn/Article/CJFDTOTAL-HBYX201911002.htm

    Chinese Diabetes Society, Chinese Society of Infectious Diseases, Chinese Society for Tissue Repair and Regeneration. Chinese guideline on prevention and management of diabetic foot (2019 edition)(I)[J]. Chinese Journal of Diabetes Mellitus, 2019, 11(2): 92-93, 108. https://www.cnki.com.cn/Article/CJFDTOTAL-HBYX201911002.htm
    [18]
    吴景竹, 侯旭宏, 曹建文, 等. 上海糖尿病患者经济负担的深度访谈报告[J]. 医学与哲学(B), 2018, 39(8): 93-97. https://www.cnki.com.cn/Article/CJFDTOTAL-YXZL201808029.htm

    WU J Z, HOU X H, CAO J W, et al. Economic burden of diabetes in Shanghai: an in-depth interview report[J]. Medicine & Philosophy, 2018, 39(8): 93-97. https://www.cnki.com.cn/Article/CJFDTOTAL-YXZL201808029.htm
    [19]
    王爱红, 许樟荣, 纪立农. 中国城市医院糖尿病截肢的临床特点及医疗费用分析[J]. 中华医学杂志, 2012, 92(4): 224-227.

    WANG A H, XU Z R, JI L N. Clinical characteristics and medical costs of diabetics with amputation at central urban hospitals in China[J]. National Medical Journal of China, 2012, 92(4): 224-227.
    [20]
    BOODOO C, PERRY J A, LEUNG G, et al. Cost-effectiveness of telemonitoring screening for diabetic foot ulcer: a mathematical model[J]. CMAJ Open, 2018, 6(4): E486-E494.
    [21]
    中华医学会糖尿病学分会, 中华医学会感染病学分会, 中华医学会组织修复与再生分会. 中国糖尿病足防治指南(2019版)(Ⅳ)[J]. 中华糖尿病杂志, 2019, 11(5): 316-317, 327. https://www.cnki.com.cn/Article/CJFDTOTAL-HBYX201911002.htm

    Chinese Diabetes Society, Chinese Society of Infectious Diseases, Chinese Society for Tissue Repair and Regeneration. Chinese guideline on prevention and management of diabetic foot (2019 edition) (Ⅳ)[J]. Chinese Journal of Diabetes Mellitus, 2019, 11(5): 316-317, 327. https://www.cnki.com.cn/Article/CJFDTOTAL-HBYX201911002.htm
    [22]
    上海市统计局. 2019年上海市国民经济和社会发展统计公报[EB/OL]. (2020-03-09)[2021-02-05]. http://tjj.sh.gov.cn/tjgb/20200329/05f0f4abb2d448a69e4517f6a6448819.html.

    Shanghai Municipal Bureau of Statistics. 2019 Shanghai Statistical Bulletin of National Economic and Social Development[EB/OL]. (2020-03-09)[2021-02-05]. http://tjj.sh.gov.cn/tjgb/20200329/05f0f4abb2d448a69e4517f6a6448819.html.
    [23]
    张晓梅, 许樟荣, 冉兴无, 等. 中国2型糖尿病下肢动脉病变的筛查研究: China-DiaLEAD研究临床意义与结果解读[J]. 中华糖尿病杂志, 2020, 12(11): 870-873. https://www.cnki.com.cn/Article/CJFDTOTAL-SHEY201709008.htm

    ZHANG X M, XU Z R, RAN X W, et al. Screening study of lower extremity arterial disease in type 2 diabetes mellitus in China: clinical significance and result interpretation of China-DiaLEAD study[J]. Chinese Journal of Diabetes Mellitus, 2020, 12(11): 870-873. https://www.cnki.com.cn/Article/CJFDTOTAL-SHEY201709008.htm
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(4)  / Tables(2)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (364) PDF downloads(8) Cited by()
    Proportional views
    Related

    Address：No. 287, Changhuai Road, Bengbu, Anhui Province, 233004, P.R.ChinaphoneNo：0552-3066635； 0552-3051890Email：zhqkyx@163.com

    Copyright © Chinese Journal of General Practice皖ICP备2020018345号-2

    Supported by: Beijing Renhe Information Technology Co., Ltd.    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return