卫生技术经济评价方法在唐氏综合征产前筛查方案选择中的应用探讨

Probe into the Application of Health Economic Evaluation Methods in Prenatal Screening Scheme for Down's Syndrome

目的:探讨技术经济方法在卫生技术经济评价中的应用。方法:以唐氏综合征两种筛查方案的实际数据为案例,应用技术经济分析方法,进行卫生技术经济评价分析。结果:在卫生技术评价中,结合具体数据的技术特征,应用微观经济学平均成本、边际成本,以及总收益和总成本函数曲线进行必要的拟合,可给出相对精确的最大效率和最大效益的判断。现行卫生技术经济评价中的增量分析存在一定的误区。结论:在技术自身灵敏度变化或诊疗技术组合要素变化的条件下,当其技术效率呈边际递减规律时,增量成本效果比的计算应采用正统方式,且其值的判别,并非愈小愈好。

Objective： To probe into the health economic evaluation methods in prenatal screening scheme for Down＇s syndrome. Methods： Health economic evaluation methods were adopted to evaluate the practical data of various prenatal screening schemes for Downg Syndrome which was as the concrete cases. Results ： ①Curve fittings for functions of average cost, marginal cost, total benefit and total cost were implemented according to the principles of microeconomics. Smoothing formula could be gotten to evaluate the best result according to the interpolation method. ②Current incremental cost -effectiveness analysis was mislead in the area of health economic evaluation. When the function was considered as law of diminishing marginal productivity, the incremental analysis showed that the value of incremental cost - effectiveness ratio was not getting better as the ratio was getting smaller. Conclusion ： Curve fittings for the screening data and incremental cost - effectiveness analysis are two important health economic evaluation methods of prenatal screening for Down＇s syndrome.