广东省梅毒综合防治示范区梅毒干预策略的卫生经济学评价

发布时间：2018-03-31 16:43

本文选题：梅毒　切入点：成本及成本分析　出处：《中华疾病控制杂志》2017年04期

【摘要】：目的对广东省梅毒综合防治示范区梅毒干预策略进行卫生经济学评价,为优化和制定梅毒防控策略提供科学依据。方法考虑两种梅毒干预策略:80%梅毒筛查覆盖率(策略1)和85%梅毒筛查覆盖率(策略2)。通过示范区现场调查和文献查阅获得相关参数,建立梅毒筛查的Markov模型,模拟1万名梅毒高危人群分别在两种策略下20年的社会总成本和期望健康结局,进行成本效果分析和敏感性分析。结果策略2相比于策略1,增加成本3 998.88万元,但能够避免28例一期梅毒、34例二期梅毒、337例潜伏期梅毒以及8例三期梅毒病例的发生,挽救392伤残调整寿命年(disability adjusted life years,DALYs),增量成本效果比为10.195万元/DALYs。敏感性分析提示,当梅毒发病率和晚期梅毒进展到三期梅毒概率越高,二期梅毒和晚期潜伏梅毒的治疗率越低时,梅毒筛查会具有更多的成本效果。结论示范区采取的梅毒干预策略具有成本效果,该项目具有可推广性。
[Abstract]:Objective to evaluate the intervention strategy of syphilis in the demonstration area of comprehensive prevention and treatment of syphilis in Guangdong Province by health economics. Methods two syphilis intervention strategies: 80% syphilis screening coverage (strategy 1) and 85% syphilis screening coverage (strategy 2) were considered. A Markov model for syphilis screening was established to simulate the total social cost and expected healthy outcome of 10, 000 high-risk syphilis populations for 20 years under the two strategies, respectively. Results compared with strategy 1, the cost of strategy 2 increased by 3 9.9888 million yuan, but it could avoid 28 cases of primary syphilis, 34 cases of secondary syphilis, 337 cases of latent syphilis and 8 cases of third stage syphilis. The sensitivity analysis showed that the higher the incidence of syphilis and the higher the probability of advanced syphilis progression to tertiary syphilis, the lower the treatment rate of secondary syphilis and late latent syphilis. Conclusion the syphilis intervention strategy adopted in the demonstration area has cost effect and the project is extensible.
【作者单位】：无锡市疾病预防控制中心公共卫生部;南方医科大学皮肤病医院性病控制科;中山大学公共卫生学院医学统计与流行病学系;
【基金】：广东省医学科研基金(C2016021)
【分类号】：R759.1;R183

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