低流行状态下麻风病症状监测的卫生经济学评价  

Health economic evaluation on the monitoring system of leprosy suspicious symptoms under low-epidemic status

作　　者：黄燕惠 叶云凤[2] 李丽梅 黄志明[2] HUANG Yanhui;YE Yunfeng;LI Limei;HUANG Zhiming(Public Heath Service Center,Bao'an District,Shenzhen,Guangdong 518126,China;Bao'an District Chronic Disease Control Hospital,Shenzhen)

机构地区：[1]深圳市宝安区公共卫生服务中心,广东深圳518126 [2]深圳市宝安区慢性病防治院

出　　处：《现代疾病预防控制》2024年第4期292-296,共5页MODERN DISEASE CONTROL AND PREVENTION

基　　金：宝安区医疗卫生基础研究项目(2019JD463)。

摘　　要：目的分析低流行状态下深圳市宝安区麻风病症状监测运行效果和经济学意义,为卫生资源合理、有效地使用提供科学依据。方法汇总、整理2011—2020年宝安区麻风病症状监测的相关资料,通过成本-效果、成本-效用、成本-效益等分析方法,对监测情况进行卫生经济学评价。结果2011—2020年宝安区开展麻风病症状监测共投入1794377.82元,确诊麻风病患者41例,每新发1例麻风病,平均投入43765.31元,与实施麻风病症状监测前10年(2001—2010年)新发的39例相比,每例新发病例平均延迟期缩短18.51个月,新发病例平均延迟期每缩短1月,需投入机构防治成本为2305.13元;平均误诊次数减少1.46次,病例误诊次数每减少1次,需投入机构防治成本为29224.62元;避免发生Ⅱ级畸残病例数2例,每避免1例畸残病例,需投入机构防治成本874692.91元。症状监测运行可挽救DALY 94.44个,总效益为8868421.70元,净收益为7074043.88元,成本效益比为1∶5。结论麻风病症状监测具有较好的卫生经济学效益,是应对麻风低流行状态、有效发现早期患者的防治工作模式。Objective To analyze the performance and economic significance of leprosy suspicious symptoms monitoring system in Bao'an district,Shenzhen,and provide scientific evidence for rationally utilizing health economic resources.Methods The data from the leprosy suspicious symptoms monitoring system from 2011-2020 were collected;the health economic evaluation on the monitoring system was conducted using the cost-effectiveness analysis,cost-utility analysis and cost-benefit analysis methods.Results The total investment for monitoring system was 1794377.82 yuan from 2011-2020,and 41 cases of leprosy were diagnosed.The average cost was 43765.31 yuan per new case.The average duration of delayed diagnosis was shortened by 18.51months per new case compared to years before leprosy suspicious symptoms monitored(2001-2010),and the average cost of institutional prevention and treatment was 2305.13 yuan for shortening the delayed-diagnosis duration by one month per new case.The average times of misdiagnosis was reduced by 1.46 times per new case,and the average cost of institutional prevention and treatment was 29224.62 yuan for avoiding one misdiagnosis.Two cases with level-2 disability were avoided,and the average cost of institutional prevention and treatment was 874692.91 yuan for avoiding one cases with disability.The symptoms monitoring saved 94.44 DALYs;the total benefit of was 8868421.70 yuan,and the net benefit was 7074043.88 yuan.The costbenefit ratio was 5.Conclusions The leprosy suspicious symptom monitoring system has good health economic benefits and is a prevention and treatment model for responding to the low prevalence of leprosy and effectively detecting early patients.

关 键 词：卫生经济学效益 麻风病 症状 监测 

分 类 号：R755[医药卫生—皮肤病学与性病学]