育龄人群孕前优生中医预防保健服务包的成本-效果分析

发布时间：2019-02-15 08:22

【摘要】：目的:评估孕前优生中医预防保健服务包改善女性生育能力的成本效果,为推广中医治未病在育龄人群中的应用提供决策依据。方法:采用整群随机抽样方法,抽取河南省焦作市和新乡市7个区县,选择2015年12月—2016年1月参加孕前优生健康检查的育龄妇女(806人)纳入研究。干预组在优生健康指导的基础上,应用项目专家组编制的孕前优生中医预防保健服务包对不同体质的育龄妇女进行干预;对照组仅采用传统的优生健康指导,不辅以中医体质干预措施。在干预后第6个月评价育龄女性的受孕情况。利用全成本测算法对干预组和对照组的成本进行核算,并计算成本-效果比。结果:干预组6个月成功受孕率为35.81%,对照组为23.83%,差异有统计学意义(P=0.001 4)。成本-效果分析后发现,干预组每成功受孕1例的成本为385.46元,对照组为534.90元,中医预防保健服务包具有较好的成本-效果比。敏感度分析发现,在人员工资水平正常波动范围内,本研究结果趋于稳定。结论:孕前优生中医预防保健服务包在改善育龄女性生育力方面优于传统的优生健康指导,且成本效果更佳。
[Abstract]:Objective: to evaluate the cost effect of prophylaxis and health care package for preconception in improving female fertility, and to provide decision basis for popularizing the application of traditional Chinese medicine (TCM) in the population of childbearing age. Methods: seven districts and counties of Jiaozuo City and Xinxiang City, Henan Province were selected by cluster random sampling, and 806 women of childbearing age (806 women) who participated in pre-pregnancy health examination from December 2015 to January 2016 were selected. On the basis of health guidance of eugenics, the intervention group used the pre-pregnancy prophylaxis health care package developed by the expert group of the project to interfere with women of different physical constitution of childbearing age. The control group only used the traditional health guidance of eugenics, without TCM physique intervention. The pregnant status of women of childbearing age was evaluated 6 months after intervention. The cost of intervention group and control group were calculated by the method of full cost calculation, and the cost-effect ratio was calculated. Results: the successful pregnancy rate was 35.81 in the intervention group and 23.833 in the control group (P < 0.001). Cost-effect analysis showed that the cost of each successful pregnancy in the intervention group was 385.46 yuan and that in the control group was 534.90 yuan. The cost of the traditional Chinese medicine preventive health care package was better than that of the control group. Sensitivity analysis shows that the results of this study tend to be stable in the range of normal fluctuation of wage level. Conclusion: prophylaxis and health care package of pre-pregnancy eugenics is superior to traditional eugenic health guidance in improving fertility of women of childbearing age, and the cost effect is better.
【作者单位】：国家卫生计生委科学技术研究所;北京协和医学院研究生院;
【基金】：国家“十二五”科技支撑计划项目(2012BAI41B08)
【分类号】：R271

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