上海市中小学生接种甲型H1N1流行性感冒疫苗的成本-效益分析  

A cost-benefit analysis of the influenza H1N1 vaccination in the primary and junior school in Shanghai

作　　者：赵根明[1] 陈健[1,2] 张涛[1] 蔡华[1] 王丹[1] 顾宝柯[2] 于淼[1] 陈昕[3] 刘杰[2] 袁政安[2] 

机构地区：[1]复旦大学公共卫生学院流行病学教研室公共卫生安全教育部重点实验室,上海200032 [2]上海市疾病预防控制中心急性传染病防治科 [3]上海市卫生局疾病预防妇幼保健处

出　　处：《中华预防医学杂志》2011年第8期737-741,共5页Chinese Journal of Preventive Medicine

基　　金：上海市卫生局青年基金（2009Y002）

摘　　要：目的 评价上海市中小学生接种甲型H1N1 流行性感冒（简称甲流）病毒裂解疫苗（简称甲流疫苗）的成本效益。 方法 研究采用准试验设计，在上海市6个区县的中小学生中开展甲流疫苗接种和效益评估，共观察414 636名中小学生。按自愿原则，将研究对象分为接种组（233 445名）和对照组（181 191名）。采用问卷调查方法在上海市19个区县预防接种机构收集疫苗接种成本信息；通过问卷调查和回顾性病历摘录等方法收集就医成本信息，其中包括31例轻症、15例重症甲流病例。最后采用卫生经济学评估方法进行流行性感冒（简称流感）疫苗的成本-效益分析。结果 研究共观察414 636名中小学生，其中接种组233 445名，对照组181 191名，接种率56.3%。疫苗接种后，接种组流感罹患率为0.61%（1433/233 445），对照组罹患率为1.76%（3166/181 191），接种组流感样病例保护率为65.34% [（1.76–0.61）/1.76]。人均接种甲流疫苗的成本为36.81元。轻症甲流病例门诊费用为（358.3±243.6）元，甲流重症病例住院费用为（49 188.4±99 917.3）元。中小学生甲流疫苗接种总效益为19 155 566.3元；接种净效益为10 560 673.7元，效益-成本比为2.24：1。结论 上海市中小学生接种甲流疫苗有一定的保护效果，是一种值得尝试的干预策略。Objective To evaluate the cost-benefit for the Influenza Type A H1N1 Virus （Influenze H1N1） vaccination in Shanghai primary and junior schools. Methods A semi-experiment study was selected to evaluate the cost-benefit for Influenza H1N1 vaccination in primary and junior schools in 6 disctricts of Shanghai, including 414 636 students in total. According to the voluntary principle, the students were divided into the vaccinated group （233 445 students） and control group （181 191 students）. The information of vaccine cost was collected from CDC in 19 districts in Shanghai by questionnaire; and the information of medical treatment cost was collected from questionnaire and abstracts of retrospective medical records, which included 31 mild cases and 15 severe cases. The cost-benefit analysis was conducted by health economic evaluation. Results In total, there were 414,636 students enrolled in this study; while 233,445 （56.3%） students were in the vaccinated group and 181 191 in the control group. The attack rate in vaccinated group and control group was 0.61%（1433/233 445） and 1.76%（3166/181 191） respectively. The protection ratio was 65.34% （（1.76-0.61）/1.76） in the vaccinated group. The average cost of Influenza H1N1 was 36.81 Yuan/person; and the average cost of medical treatment was （358.3±243.6） yuan/mild case and （49 188.4±99 917.3） yuan/severe case. The total benefit of vaccination in schools was 19,155,566.3 yuan, and the net benefit was 10,560,673.7 yuan. Therefore, the benefit-cost ratio was 2.24：1. Conclusion Influenza H1N1 vaccine could protect the students from Influenza H1N1 infection, and the cost-benefit analysis showed that the intervention strategy was worth trying.

关 键 词：流感 人 流感疫苗 接种 费用效益分析 

分 类 号：R186[医药卫生—流行病学]