中医药对痴呆症治疗效果和成本的影响:一项回顾性真实世界研究的结果

IF 3.4 3区 医学 Q2 GERIATRICS & GERONTOLOGY Aging Clinical and Experimental Research Pub Date : 2024-10-12 DOI:10.1007/s40520-024-02858-9
Yi-Xiang Weng, Chien-Chung Yang, Wen-Chuin Hsu, Raymond N. Kuo
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引用次数: 0

摘要

目标本研究旨在利用真实世界的数据,评估传统中医药(TCM)对痴呆症患者的影响。具体而言,研究旨在通过考察临床痴呆评分(CDR)和迷你精神状态检查(MMSE)分数的变化,以及两年内中医对医疗费用的影响,评估中医如何影响临床疗效。为了实现这些目标,我们将使用一个跨度为 2004 年至 2021 年的多中心研究数据库中的数据,以弥补目前在直观结果和认知功能评估方面的经验数据缺口。由于因变量的重复测量,研究人员采用了广义估计方程来控制社会人口特征、地区特征以及西医治疗痴呆症的方法:其中中医干预组 90 人,非中医干预组 351 人。多变量回归分析结果显示,与非中医干预组相比,中医干预组的 MMSE 评分每年增加 0.608 分。中医干预组 CDR 评分的年变化是非中医干预组的 0.702 倍。中医干预后,与未干预组相比,每年的门诊费用增加了 492.2 美元,住院费用增加了 324.3 美元,总医疗费用增加了 815.9 美元。然而,这些益处伴随着医疗费用的增加,尤其是门诊护理费用的增加。未来的医疗策略应在中医的认知益处和经济影响之间取得平衡,倡导将中医纳入痴呆症护理方案。
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Effects of traditional Chinese medicine on outcomes and costs of dementia care: results from a retrospective real-world study

Objectives

This study aims to assess the impact of Traditional Chinese Medicine (TCM) on dementia patients, utilizing real-world data. Specifically, it seeks to evaluate how TCM influences clinical outcomes by examining changes in the Clinical Dementia Rating (CDR) and Mini-Mental State Examination (MMSE) scores, as well as its effect on medical expenses over a two-year period. Data from a multi-center research database spanning from 2004 to 2021 will be used to achieve these objectives, addressing the current gap in empirical data concerning intuitive outcomes and cognitive function assessments.

Methods

Propensity score matching was adopted to improve comparability among the intervention and control groups. Due to repeated dependent variable measurements, the generalized estimating equation was used to control for socio-demographic characteristics, regional characteristics, and Western medicine treatments for dementia.

Results

After propensity score matching, a total of 441 research subjects were included: 90 in the TCM intervention group and 351 in the non-TCM intervention group. The results of multivariate regression analysis showed that compared with the non-TCM intervention group, the MMSE scores in the TCM intervention group increased by 0.608 points each year. The annual change in CDR scores in the TCM intervention group was 0.702 times that of the non-TCM utilization group. After TCM intervention, annual outpatient expenses increased by US$492.2, hospitalization expenses increased by US$324.3, and total medical expenses increased by US$815.9, compared with the non-intervention group.

Conclusions

TCM interventions significantly decelerate cognitive decline in dementia patients, evidenced by slower reductions in MMSE scores and mitigated increases in CDR scores. However, these benefits are accompanied by increased medical expenses, particularly for outpatient care. Future healthcare strategies should balance the cognitive benefits of TCM with its economic impact, advocating for its inclusion in dementia care protocols.

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来源期刊
CiteScore
7.90
自引率
5.00%
发文量
283
审稿时长
1 months
期刊介绍: Aging clinical and experimental research offers a multidisciplinary forum on the progressing field of gerontology and geriatrics. The areas covered by the journal include: biogerontology, neurosciences, epidemiology, clinical gerontology and geriatric assessment, social, economical and behavioral gerontology. “Aging clinical and experimental research” appears bimonthly and publishes review articles, original papers and case reports.
期刊最新文献
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