新疆麻疹强化免疫的经济与社会效益分析

发布时间：2018-02-08 09:04

本文关键词： 麻疹麻疹疫苗成本-效果成本-效益社会效益经济效益　出处：《新疆医科大学》2007年硕士论文　论文类型：学位论文

【摘要】： 背景:麻疹是一种严重危害儿童健康的急性呼吸道传染病,患病后易发生严重的并发症,迄今仍是低龄儿童中疫苗可预防性传染病导致死亡的首要原因之一。包括我国在内的世界卫生组织西太平洋区域每年大约有3万名儿童死于麻疹。因此其危害在疫苗可预防疾病中仍占有重要地位。目前WHO已将麻疹定为继天花、脊髓灰质炎之后的第三个将被消除或消灭的疾病,2005年我国所在的WHO西太平洋区所有国家承诺到2012年消除麻疹。中国于1965年开始应用麻疹疫苗,特别是1978年开展计划免疫后,麻疹发病已得到有效控制。但是,部分省(市、区)常规免疫的滑坡导致近几年麻疹发病率在我国重新抬头。1999-2001年,全国麻疹病例每年都以20%以上的速度增加。我区麻疹发病率在全国32个省(市、区)中占第二位,是造成全国麻疹发病率上升的主要贡献者之一。2004年在我区范围内出现了麻疹暴发或流行,导致2004年麻疹报告发病率上升为34/10万,跃居全国首位。针对这种态势,在卫生部和自治区人民政府的大力支持下,2004年11月25日至12月1日,在全区范围内对8月龄至13岁儿童成功地实施了一轮麻疹强化免疫。其接种范围之广、接种儿童数量之多、投入人力物力之大,在我区是史无前例的。对于实行的任何一项卫生规划,我们在关注其所能带来的社会效益的同时,也应该重视其所能产生的经济效益。这就需要对每一项卫生策略进行经济学评价,评价的结果对卫生决策部门合理、高效的利用有限卫生资源具有重要的指导意义。本研究欲从卫生经济学角度对我区麻疹疫苗强化免疫预防策略进行社会和经济效益方面的研究,定量了解我区麻疹强化免疫的投入情况以及所产生的社会效益和经济效益,全面考虑强化免疫策略的经济性,通过数据显示预防接种在经济建设中的作用,为政府制定和完善免疫策略、保证卫生资源的优化配置提供依据。目的:对我区麻疹疫苗强化免疫预防策略进行系统的卫生经济学评价。评价的结果有利于指导麻疹免疫预防策略的调整和完善,有利于有限卫生资源得以优化配置。方法:采用卫生经济学评价方法进行分析。本课题以我区2004年麻疹疫苗强化免疫活动为背景,采用以下研究路线进行研究。(1)根据我区2004年麻疹强化免疫活动的硬件投入和软件投入费用,计算出我区2004年麻疹强化免疫的成本;(2)结合强化免疫前后麻疹报告发病率,推算出我区实施麻疹强化免疫后减少的发病人数,此即为我区麻疹强化免疫预防策略获得的社会效益;(3)选择我区2004年麻疹患者作为经济效益研究的对象人群,计算其因感染麻疹所引起的直接、间接经济损失。进而结合麻疹强化免疫后减少的发病人数,推算出我区因实施麻疹强化免疫可避免的各种经济损失,此即为我区麻疹强化免疫预防策略获得的经济效益;(4)运用卫生经济学评价中的成本-效果、成本-效益分析方法评价我区麻疹强化免疫预防策略的经济和社会效益。结果:2004年我区麻疹疫苗强化免疫投入的成本共计1042万元;麻疹患者的直接经济损失为4031元,间接经济损失为600元;强化免疫后的两年半内有9705人免于发生麻疹,获得的直接经济效益为4071.84万元,间接经济效益为606.58万元,总效益为4678.42万元;麻疹疫苗强化免疫策略的总BCR值为4.49,净效益值为3636.42万元,说明该策略获得了很好的经济效益和社会效益。结论:我区实行的麻疹疫苗强化免疫策略,其效益-成本值远大于1,说明在该项措施上进行投资取得了远远超过成本的经济效益,因此我区2004年麻疹强化免疫预防策略具有经济学上的可行性。麻疹强化免疫的效益-成本值是动态变化的,我们应对其做出长期动态评价,推进预防接种工作,更高效地预防和控制麻疹的传播,更有效地利用有限的卫生资源。
[Abstract]:Background: measles is an acute respiratory infectious disease seriously endangering children's health, illness prone to serious complications, so far is still young children in the vaccine preventable diseases caused the death of one of the primary reasons. There are about 30 thousand children died of measles in China including the West Pacific Regional WHO each year. So the harm can still play an important role in disease prevention in the vaccine. Now WHO has been set for measles after smallpox, polio after the third would be to eliminate or eradicate the disease, in 2005 China where the WHO West Pacific region all countries committed to the elimination of measles in 2012. Chinese began in 1965 of the measles vaccine, especially in 1978 after immunization, measles incidence has been effectively controlled. However, part of the province (city, district) routine immunization landslides in recent years, the incidence of measles in our country The rise of.1999-2001 years, the measles cases annually increasing at a rate of more than 20%. The incidence of measles in our region in 32 provinces (cities, districts) accounted for second, which is the main contribution of the increased incidence of measles among the.2004 in my area had measles outbreak, resulting in 2004 the reported incidence of measles rose 34/10 million, ranked first in the country. In view of this situation, in support of the Ministry of health and the autonomous region of the people's government, from November 25, 2004 to December 1st, in the region of 8 month old to 13 year olds successfully implemented a measles immunization. The breadth of its coverage, the number of children vaccinated. More investment in human resources is large, in my area. There was no parallel in history. for any health plan implementation, we can bring attention to their social benefits at the same time, should also pay attention to their produce economic Benefit. This needs to carry on economic evaluation of each health strategy, the evaluation results of the health decision-making department is reasonable, has an important guiding significance to the efficient use of limited health resources. For this study from the perspective of health economics Xinjiang measles vaccine immunization for the prevention of social and economic benefits in terms of strategy, quantitative understanding of the input region measles immunity and the social and economic benefits, comprehensive consideration of strengthening economic immunity strategy, through the data show that the preventive effect of vaccination in economic construction, for the government to formulate and improve immunization strategy, ensure the basis for optimizing the allocation of health resources.
Objective: To evaluate the preventive strategies of measles vaccine in our district systematically and hygienic economics. The results of the evaluation are helpful to guide the adjustment and improvement of measles immunization strategy, and to optimize the allocation of limited health resources.
Methods: the evaluation of health economics analysis. In this paper I 2004 measles immunization activities as the background, the following line of research. (1) according to the hardware and software investment in our region in 2004 measles immunization activities cost calculated in our region in 2004 measles immunization costs; (2) combining the measles immune reporting rate before and after the projected implementation of the incidence of measles immunization reduced in our region, namely Xinjiang measles vaccination strategy to strengthen the social benefits; (3) selection of measles in Xinjiang in 2004 as the economic benefits of target groups, calculated from the measles infection caused by the direct the incidence, indirect economic loss. Then after immunization with the measles reduction, I calculate the area due to various economic loss of measles immunization can be avoided, this is my area The economic benefits of measles intensified immunization strategy were achieved. (4) the cost-effectiveness analysis and cost-benefit analysis method were used to evaluate the economic and social benefits of measles immunization strategy in our area.
Results: in 2004 the measles vaccine immunization total investment cost of 10 million 420 thousand yuan; the direct economic loss of measles patients is 4031 yuan and the indirect economic loss of 600 yuan; immunization after two and a half years with 9705 people from measles, the direct economic benefit of 40 million 718 thousand and 400 yuan, the indirect economic benefit is 6 million 65 thousand and 800 yuan, the total the benefit is 46 million 784 thousand and 200 yuan; measles vaccine strengthening immunization strategy of the total BCR value is 4.49, the net benefit was 36 million 364 thousand and 200 yuan, indicating that the strategy was a good economic and social benefits.
Conclusion: measles vaccine immunization strategy in our region to implement, the benefit cost is greater than 1, the investment in the measure has been far more than the cost of economic benefits, so I in 2004 to strengthen measles immunization strategy for the prevention of the feasibility of economics. Measles immunization costs is the effectiveness of dynamic change, we should make its long-term dynamic evaluation, promote vaccination, dissemination of more efficient prevention and control of measles, more effective use of limited health resources.

【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2007
【分类号】：R186

【引证文献】