【作者】 刘国恩； 常精华； 徐程； 温丽； 何继明； 刘超； 桑滨生；

【Author】 Gordon Liu (Guanghua School of Management, Peking University, Beijing 100871, China) Chang Jinghua, Wen Li, Liu Chao (China Center for Pharmacoeconomics & Outcomes Research, Peking University, Beijing 100871, China) Xu Cheng (School of Public Administration, Southwestern University of Finance and Economics, Chengdu 610074, China) He Jimin(Guangzhou Medical Insurance Service Management Center, Guangzhou 510635, China) Sang Binsheng (State Administration of Traditional Chinese Medicine of the PRC, Beijing 100026, China)

【机构】 北京大学光华管理学院； 北京大学中国医药经济研究中心； 西南财经大学公共管理学院； 广州市医疗保险服务管理中心； 国家中医药管理局政策法规与监督司；

【摘要】 目的:应用现代经济学计量模型方法,本文对中医、西医与中西医结合在治疗原发性非小细胞肺癌(IIIB~IV期)的效果进行了实证比较分析。方法:数据样本取自广州6家医院2007年因原发性非小细胞肺癌(IIIB~IV期)入院的608个临床病例,评价治疗效果的产出变量(outcomes variables)包括KPS评分差值与临床症状,控制干扰因素变量,计量估计模型同时还考虑了包括样本选择误差(sample selection bias)等组间的非观察性影响因素。结果:在控制了其他影响因素后,中医和中西医结合治疗提升患者KPS评分等级的OR值分别是西医治疗的3.19倍和2.16倍。剔除部分死亡病例后的子样本模型结果进一步显示,中医药治疗具有更显著的比较优势。另外,在细分症状指标好转率方面,中医与中西医也体现出一定的好转优势。结论:中医药在治疗非小细胞肺癌方面确有比较优势。有关中医药在治疗其他病种上的潜在优势,可以借助现代计量经济模型的实证方法,进行科学、客观的比较分析,发挥其应有的作用,促进医疗资源的配置效率和国民健康福利的提高。更多还原

【Abstract】 OBJECT: The econometric research is applied to evaluate the clinical, economic outcomes and quality of life of Traditional Chinese Medicine (TCM) for the treatment of stage IIIB~IV non-small cell lung cancer (NSCLC). METHODS: NSCLC inpatient medical records in 6 hospitals in Guangzhou in 2007 are collected to develop a database. Econometric methods, Ordered Logistic Estimation and Logistic Regression are applied to analyze Karnofsky Performance Status Scale (KPS) and clinical symptoms respectively among TCM therapy, western medicine therapy and combined therapy. RESULTS: Compare to western medicine, both TCM therapy and combined therapy have significantly improved KPS and clinical symptoms. The results of leaving out the death sample show that TCM therapy has more advantages in these indicators. CONCLUSION: TCM proves to have economic advantage in the treatment of advanced NSCLC. Health care economic analyses of TCM provide useful information for rational therapeutic decisions that could be utilized to maximize societal health benefits.更多还原