非药物干预应用于COVID-19防控的卫生经济学评价的系统评价  

Health economic evaluation of non-pharmaceutical interventions for COVID-19 prevention and control:a systematic review

作　　者：翁俊岭 连代 陶颖 罗冰星[1,2] 李福明 严俊涛 杨毅[1,2] 陈英耀 WENG Junling;LIAN Dai;TAO Ying;LUO Bingxing;LI Fuming;YAN Juntao;YANG Yi;CHEN Yingyao(School of Public Health,Fudan University,Shanghai 200032,P.R.China;National Health Commission Key Laboratory of Health Technology Assessment,Fudan University,Shanghai 200032,P.R.China)

机构地区：[1]复旦大学公共卫生学院,上海200032 [2]国家卫生健康委员会卫生技术评估重点实验室,复旦大学,上海200032

出　　处：《中国循证医学杂志》2023年第6期654-664,共11页Chinese Journal of Evidence-based Medicine

摘　　要：目的系统评价COVID-19相关非药物干预(NPIs)的经济学评价研究。方法计算机检索CNKI、WanFang Data、SinoMed、Web of Science、PubMed、EMbase、Cochrane Library和INAHTA数据库,搜集与COVID-19 NPIs相关的卫生经济学评价研究,检索时限为2020年1月1日至2022年8月20日,并根据纳入与排除标准进行文献筛选、资料提取和数据整合分析。结果共纳入71篇文献,其中25篇涉及核酸、抗原检测和筛查类NPIs,5篇聚焦于个人防护类NPIs,12篇关于社交距离与隔离类NPIs,11篇为区域或全国性封锁措施类NPIs,18篇包含多种NPIs组合。相较于无干预,核酸、抗原检测、筛查和个人防护类的措施均具有经济性,社交距离和隔离等措施也具有经济性,但在低等收入国家,可能会给最贫穷和最脆弱的人造成沉重的损失。此外,相较于单次长期的区域封锁,多次短期的封锁措施更具经济性。结论核酸和抗原检测、个人防护、社交距离和隔离等NPIs在一定程度上均具有经济性;区域或全国性的封锁虽然可以减少死亡,但不适宜广泛采用。针对Omicron变异株,免疫缺陷人群、老年人群等特殊群体以及我国背景下NPIs的经济学价值仍需进一步探索。Objective To systematically review the economy of non-pharmaceutical interventions(NPIs)for COVID-19.Methods The Web of Science,PubMed,EMbase,Cochrane Library,INAHTA,CNKI,WanFang Data and SinoMed databases were electronically searched to collect studies on health economic evaluations from 1 January 2020 to 20 August 2022.Then the included materials were reviewed,extracted and data integration analysis were conducted based on inclusion and exclusion criteria.Results Seventy-one academic publications were finally included,which contained 25 papers about nucleic acid testing,antigen testing and screening,5 papers about personal protection,12 papers about social distancing,quarantine and isolation,11 papers about regional or national lockdown and 18 papers about multiple NPIs.The results showed that compared with no intervention,nucleic acid testing,antigen testing,screening and personal protection measures were economical.Social distancing,quarantine and isolation were also economical compared with no intervention.However,in low-income countries,movement restriction and factory shutdown may exact a heavy toll on the poorest and most vulnerable.Moreover,compared with a single long-term lockdown,multiple short-term lockdowns could be more economical,but the cost was still huge overall.Conclusion NPIs such as nucleic acid testing,antigen testing,personal protection,social distancing,quarantine,isolation and factory shutdown are economical.Although regional or national lockdown can save lives,it is not suitable for wide use.The researches on specific populations,specific variants(especially Omicron)and in the context of China need to be carried out.

关 键 词：新型冠状病毒感染 非药物干预 卫生经济学评价 系统评价 

分 类 号：R1[医药卫生—公共卫生与预防医学]