栄養学雑誌
Online ISSN : 1883-7921
Print ISSN : 0021-5147
ISSN-L : 0021-5147
高脂血症における栄養指導のあり方と治療法別費用効果分析
足立 香代子
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ジャーナル フリー

2002 年 60 巻 5 号 p. 223-230

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The medical cost in a year was analyzed for patients with hyperlipidemia according to the Mark method for analyzing cost-effectiveness. The patients were divided into groups undergoing nutritional therapy alone (N group: 83), nutritional therapy combined with drugs (N-D group: 17), and drug therapy (D group: 20). The medical cost of \42, 122 (337 at =\125) for each patient in the N group was \90, 000-\100, 000 less expensive than the costs for the N-D group and D group, being related to the types of drugs and the complications.
Those patients with hypercholesterolemia (high TC) showed no difference in TC reduction among the groups. The patients in the N group with a TC level of more than 260mg/dl showed a greater TC reduction than those in the D group (-14.8±10.9% vs -4.7±9.7%, p<0.05). The total cost/patient in the N group was \61, 748 (494), this being \140, 000-\160, 000 less expensive than the treatment for the patients in the N-D and D groups.
The patients in the N group with a TC level of less than 260mg/dl showed a greater TC reduction than those in the D group, while the patients with a triglyceride (TG) level of more than 150mg/dl (high TG) showed no difference in TG reduction among the groups. The annual total cost/patient for the N group was \54, 367 (435), compared with \80, 000 (640) and \180, 000 (1, 440) for the N-D and D groups, respectively.
Nutritional therapy for the patients with a TC level of more than 260mg/dl and for those with high TG was more cost-effective than the treatments used for the N-D and D groups. Nutritional therapy should therefore be considered as the primary treatment in terms of reducing medical cost.
The effectiveness of treating by nutritional therapy needs to be based on a diagnosic examination and physical measurement of each patient to provide the optimum treatment.

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