广东省社区美沙酮维持治疗的评价与决策分析  

Evaluation and Decision Analysis of Methadone Maintenance Treatmentin Guangdong Province

作　　者：刘军[1] 凌莉[1] 赵醴丽[1] 林鹏[2] 何群[2] 

机构地区：[1]中山大学公共卫生学院医学统计与流行病学系,510080 [2]广东省疾病预防控制中心

出　　处：《中国卫生统计》2007年第5期501-504,共4页Chinese Journal of Health Statistics

基　　金：广东省艾滋病防治专项基金资助

摘　　要：目的通过Markov模型进行MonteCarlo模拟,对广东省社区美沙酮维持治疗进行评价与决策分析。方法建立Markov决策模型,应用MonteCarlo模拟进行成本效用分析。结果平均每个吸毒者30年中不维持治疗与维持治疗的费用分别为114.4(101.2～129.6)万元与81.9(62.4～102.3)万元,效用值分别为9.7(8.9～10.7)QALY与12.3(10.4～14.2)QALY,C/E分别为11.8(10.3～13.0)万元/QALY与6.7(4.5～9.6)万元/QALY,ICUR为-12.5万元/QALY。结论MonteCarlo试验模拟能估计成本与效用的变异,并能进行统计学检验,对于结果的预测有积极意义。Objective Developing Monte Carlo simulation by using a Markov model, to analysis the cost - effectiveness of Methadone Maintenance Treatment in Guangdong Province community. Methods Establishing a Markov decision - making model, and using Monte Carlo simulation to analysis the cost - effectiveness. Results On average the expense of each drug user not in methadone treatment （CT group） is 1144 thousand RMB. The 95% CI is 1012 thousand RMB to 1296 thousand RMB. The utility is 9.7 QALY, and 95 % CI is 8.9 to 10.7 QALY. Cost - Utility ratio （CE ratio） is 118 thousand RMB per QALY, and 95% CI is 103 to 130 thousand RMB per QALY. In Methadone maintenance treatment group （MMT group）, the cost is 819 thousand RMB, and 95% CI is 624 to 1023 thousand RMB. The utility is 12.3 QALY, and 95 % CI is 10. 4 to 14.2 QALY. CE ratio is 67 thousand RMB per QALY, 95 % CI is 45 to 96 thousand RMB per QALY. The increment cost - utility ratio （ICUR） is - 125 thousand RMB per QALY. Conclusion Monte Carlo trial simulation can estimate the deviation of cost and utility, and carry on the statistics test. It has the active effect on the result prediction.

关 键 词：MARKOV模型 MONTE CARLO模拟 成本效用分析 

分 类 号：R749.64[医药卫生—神经病学与精神病学]