云南省儿童先天性心脏病筛查标准化管理的成效分析  

Cost-effectiveness analysis of standardized management of screening for congenital heart disease in children in Yunnan Province

作　　者：杨荣益 宋俊洁 张宇 王腾 张艳梅 卢江 YANG Rongyi;SONG Junjie;ZHANG Yu;WANG Teng;ZHANG Yanmei;LU Jiang(Fuwai Yunnan Cardiovascular Hospital,Kunming Yunnan 650500,China)

机构地区：[1]云南省阜外心血管病医院,云南昆明650500

出　　处：《卫生软科学》2023年第7期1-4,共4页Soft Science of Health

基　　金：云南省心血管病临床医学中心项目(FZX2019-06-01)。

摘　　要：[目的]分析儿童先天性心脏病筛查标准化管理的成本效益情况,为有效推广高效低成本先心病筛查提供新的策略。[方法]采用横断面调查,以云南省阜外心血管病医院筛查队员所到62个县(区)为调查地点。其中以2019年1月-2020年12月为未实施筛查标准化管理,2021年1月-2022年6月为实施筛查标准化管理,比较筛查标准化管理实施前后的成本效益情况。[结果]筛查标准化管理实施前儿童先天性心脏病检出率为0.08%,实施后检出率为0.26%,总体检出率明显升高(P<0.05)。筛查标准化管理实施后简单性先天性心脏病占比明显下降(P<0.001),复杂性先天性心脏病、先天性瓣膜病占比明显上升(P<0.001);其他先天性心脏病病种占比无明显差异(P>0.05)。筛查标准化管理实施前确诊1例患儿平均花费1169.43元,实施后平均花费513.58元。筛查标准化管理实施前筛查一天支出费用为6478.27元,实施后筛查一天支出费用为5095.95元。筛查标准化管理实施前人均听诊筛查儿童数5249人、人均超声确诊儿童数467人,实施后人均听诊筛查儿童数7048人、人均超声确诊儿童数978人。[结论]筛查标准化管理实施后的儿童先心病筛查成本收益效果明显,是一种低成本高效的儿童先心病筛查新模式,可为未来儿童先心病筛查提供新的管理策略。Objective To analyze the cost-effectiveness of standardized management of screening for congenital heart disease in children and to provide a new strategy for effective promotion of efficient and low-cost congenital heart disease screening.Methods A cross-sectional survey was performed.62 counties and districts in Yunnan Province were selected as the survey sites by the screening team of Fuwai Yunnan Cardiovascular Hospital.Standardized screening management was not implemented from January 2019 to December 2020,and it was implemented from January 2021 to June 2022.The cost-effectiveness before and after the implementation of standardized screening management were compared.Results Before the implementation of standardized screening management,the rate of diagnosis of congenital heart disease in children was 0.08%,and it was 0.26%after the implementation.The rate of diagnosis had risen significantly(P<0.05).After the implementation of standardized screening management,the proportion of simple congenital heart disease decreased significantly(P<0.001),and the proportion of complex congenital heart disease and valvular heart disease increased significantly(P<0.001).There was no significant difference in the proportion of other congenital heart diseases(P>0.05).The average cost of a confirmed case of children before the implementation of standardized screening management was 1169.43 yuan,and the average cost was 513.58 yuan after the implementation.Before the standardized screening management,the daily expenditure of screening was 6478.27 yuan.After the implementation,the daily expenditure of screening was 5095.95 yuan.Before the implementation of standardized screening management,5249 children were screened by auscultation per doctor and 467 children were diagnosed by ultrasound per doctor.After the implementation,7048 children were screened by auscultation per doctor and 978 children were diagnosed by ultrasound per doctor.Conclusions After the implementation of standardized screening management,the cost-effectivenes

关 键 词：先心病 筛查 标准化管理 

分 类 号：R179[医药卫生—妇幼卫生保健]