基于Markov模型的标准化测压应用于脑卒中风险管理的成本效果分析  

Cost-effectiveness analysis of standardized blood pressure measurement for stroke risk management based on Markov model

作　　者：程旻娜[1] 李洪铮 应晓华[2] 王瑞欣 严青华[1] 吴菲 俞捷[3] 高嘉宝 金迎 施燕[1,5] 周峰 付晨 CHENG Minna;LI Hongzheng;YING Xiaohua;WANG Ruixin;YAN Qinghua;WU Fei;YU Jie;GAO Jiabao;JIN Ying;SHI Yan;ZHOU Feng;FU Chen(Division of Chronic Non-communicable Disease and Injury,Shanghai Municipal Center for Disease Control and Prevention,Shanghai 200336,China;不详)

机构地区：[1]上海市疾病预防控制中心慢性非传染病与伤害防治所,上海200336 [2]复旦大学公共卫生学院 [3]上海市黄浦区疾病预防控制中心,上海200023 [4]上海市黄浦打浦桥街道社区卫生服务中心 [5]国家老年疾病临床医学研究中心

出　　处：《中国慢性病预防与控制》2023年第7期499-503,共5页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：上海市加强公共卫生体系建设三年行动计划(2020-2022)(GWV-7);上海市加强公共卫生体系建设三年行动计划公共卫生重点学科建设项目(GWV-10.1-XK16,GWV-10.1-XK05);上海市卫生健康委员会科研项目(20214Y0488)。

摘　　要：目的评价标准化测压应用于脑卒中风险管理的经济学价值,为制定高危人群筛查策略提供依据。方法收集2019年上海市黄浦区3120例标准化测压和7459例常规测压数据,通过构建Markov模型,模拟采用两种测压方式的首诊测压人群在25年间与高血压和脑卒中相关的总成本和质量调整寿命年(QALY),计算增量成本效果比(ICER),并进行单因素敏感性分析和概率敏感性分析。采用Stata 16.0软件进行χ^(2)检验或t检验。结果标准化测压组人均获得22.63个QALYs,人均成本为2676.10元;同期常规测压组人均获得22.57个QALYs,人均成本则为2313.34元;ICER值为6189.06元/QALY。结论在当前的支付水平下,标准化测压相较于常规测压具有成本效果优势。Objective To evaluate the economic value of standardized blood pressure measurement in stroke risk management and provide the basis for the strategy of screening the residents with high risk.Methods Data of 3120 standardized blood pressure measurements cases and 7459 conventional blood pressure measurements cases in Huangpu district of Shanghai in 2019 were collected.Markov model was applied to simulate the hypertension and total stroke-related costs and quality adjusted life years(QALY)during 25 years in patients with two types of pressure measurements,and incremental cost-effectiveness ratio(ICER)was calculated.One-way sensitivity analysis and probability sensitivity analysis were performed.The t test andχ^(2)test were used to analyze the data,the used software was Stata 16.0.Results The cost-effectiveness analysis showed that each patient in the standardized blood pressure measurement group obtained 22.63 QALYs and per capita cost was 2676.10 RMB;while the conventional measurement group obtained 22.57 QALYs per patient,and per capita cost was 2313.34 RMB.ICER value was6189.06 RMB/QALY.Conclusion The standardized blood pressure measurement is cost-effective as compared with the conventional blood pressure measurement at the current payment level.

关 键 词：标准化测压 臂间血压差 脑卒中 经济学评价 成本效果分析 

分 类 号：R743.3[医药卫生—神经病学与精神病学]