上海市南汇区脑卒中干预策略的成本-效果和成本-效益分析  

Cost-effectiveness Analysis on " Stroke Predict-strengthen Intervention" Primary Intervention Policy in Nanhui County of Shanghai

作　　者：黄久仪[1] 曹奕丰[1] 郭吉平[1] 牟维艳[1] 俞学海[1] 王素春[1] 王艳[1] 范柳[1] 张旭静[1] 陈海艳[1] 

机构地区：[1]上海市脑血管病防治研究所,上海200433

出　　处：《中国慢性病预防与控制》2003年第5期210-211,216,共3页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：上海市专项基金 (沪科合 99第 0 0 5号 )

摘　　要：目的评价上海市南汇区“脑卒中高危人群筛检与重点干预”一级预防策略的成本效果和效益。方法 1999年开始 ,在上海市南汇区全区近 70万干预人群中筛选 35岁及以上、至少具有一种脑卒中危险因素暴露者 ,进行脑血管血液动力学指标 (CVHI)检测 ,对 CVHI积分值≥ 70分的人群针对危险因素暴露情况给予一般干预 ,对积分值 <70分的个体 ,在一般干预的基础上服用脑安胶囊。按照项目所需的实际投入和减少脑卒中发病所需的医疗费用计算净成本 ,根据净成本和干预效果计算效果和效益指标。结果 3年的干预需要投入粗成本 3116 86 32元 ,干预 3年后因减少患者节省的医疗费用为 30 70 912 5元 ,全区 3年实施干预策略需投入净成本 4 5 95 0 7元 ,产生的主要健康效果为减少脑卒中发病10 11例 ,增加健康生命年 5 6 87年 ,增加潜在劳动年 995年 ,每减少 1例脑卒中发生需要投入净成本 4 17元 ,效益成本比为 12 .6。敏感性分析提示 ,在假设医疗费用上涨 5 %时 ,净成本减低 5 0 % ,假设劳动力价格上涨 10 % ,效益成本比为10 .1。结论“脑卒中高危险人群筛检与重点干预”是一项成本 -效果良好的一级预防策略。Objective To analyze cost-effectiveness of 'Stroke predict-strengthen intervention' primary intervention activity in Nanhui County of Shanghai.Methods Since 1999,residents in Nanhui county aged 35 and over with at least one risk factors of stroke were conducted cerebral vascular hemodynamic indexes(CVHI) examination.Those CVHIs accumulative score≥70 points received general intervention and those the score below 70 points given Naonan capsules on the basis of general intervention.The net costs were estimated according to the cost of implementing the intervention activity minus the cost being avoided owing to decreasing of stroke incidence.Results 31 168 632 RMB yuan crude costs was required for three years intervention and 30 709 125 yuan saved owing to decreasing of stroke incidence.The net costs for this intervention was 459 507 yuan.The intervention activity could prevent 1 011 persons suffer from stroke.Meanwhile,the project could increase 5 687 health life years,995 potential working years.In this intervention,417 yuan could prevent one person suffering from stroke.Conclusion 'Stroke preventing-strengthen intervention' primary intervention activity seems to be good and effective.

关 键 词：脑卒中 一级预防 成本-效果分析 

分 类 号：R743.301[医药卫生—神经病学与精神病学]