中醫臨床標準作業程序及療效評估：以氣喘、腦中風、腦性麻痺為例

孫茂峰
財團法人長庚紀念醫院
本研究擬針對長庚紀念醫院中醫醫院之「腦中風住院患者中醫會診照護」、「腦性麻痺患者中醫優質門診」、以及「氣喘病患中醫優質門診」等計劃，評估相關疾病在臨床標準作業程序下的各種效益與成本。本研究擬以問卷方式，定期收集病患與主要照護家屬的照護結果資料，以repeated measure的研究設計，利用成本效益分析方法，評估在中醫臨床標準作業程序下接受治療的病患的成本效益。同時與只接受西醫治療的病患（控制組）的結果比較，探討中西醫合治是否具有明顯成本效益的差異。在效益方面，我們考慮特定慢性病患的臨床療效、生活品質、可節省的機會成本、教學成效等等效益；在成本方面，我們考慮治療的健保支出和病患自付的費用，藉此完整地分析中西醫合治的具體成效，作為臨床照護和政策的參考。
關鍵字：臨床標準作業程序；療效評估；氣喘；腦中風；腦性麻痺

Clinical Pathways and Cost-Benefit Appraisals of the Traditional Chinese Medicine: The Cases of Asthma, Stroke, and Cerebral Palsy

Sun, Mao-Feng
Chang Gung Memorial Hospital
This study aims to appraise the costs and benefits of the traditional Chinese medicine treatments for patients of asthma, stroke and cerebral palsy under the standard procedures developed by the Chang Gung Memorial Hospital. Information of the participating patients, care-givers, teachers, and students will be collected regularly through questionnaires designed by the investigators. The data will be analyzed with repeated measures. Costs and benefits will be calculated accordingly to access the effectiveness of these standard procedures. By comparing the costs and benefits across the control group and the experiment group, we expect to test the hypothesis that the integration of the western and Chinese medicine is cost-effective for treating patients of the specific diseases. On the benefit side, we take into account the clinical effectiveness, quality of life, opportunity costs saved, education, and so forth. On the costs side, we consider the treatment costs for the health insurance, out-of-pocket expenditures, and so forth.By doing so, we hope to fully analyze the benefits and costs associated with the establishment of the standard procedures for policy and clinical purposes.
關鍵字：clinical pathways；cost-benefit；asthma；stroke；cerebral palsy