社区“三高”人群粗杂粮干预的成本效果分析

Cost-Effectiveness of Coarse Food Grain Intervention to People "Three-Hyper-Condition"

目的探讨南京市鼓楼区社区"三高"人群粗杂粮干预的成本效果,为粗杂粮干预是否具有可推广价值提供决策依据。方法对南京市鼓楼区10个社区卫生服务中心的"三高"人群进行粗杂粮干预,通过定期体检获得干预前后的体检资料,进行慢性病患者粗杂粮干预的成本效果评价。结果干预半年组与对照组比较,粗杂粮干预对收缩压、舒张压、空腹血糖、总胆固醇、三酰甘油、高密度脂蛋白胆固醇水平影响的增量成本效果比分别为18.11元/mmHg、16.91元/mmHg、110.32元/(mmol/L)、150.16元/(mmol/L)、107.77元/(mmol/L)、280.65元/(mmol/L);干预1年组与干预半年组比较,粗杂粮干预对收缩压、舒张压、空腹血糖、总胆固醇、三酰甘油、高密度脂蛋白胆固醇水平影响的增量成本效果比分别为421.99元/mmHg、272.12元/mmHg、409.79元/(mmol/L)、1045.35元/(mmol/L)、782.93元/(mmol/L)、2762.17元/(mmol/L)。结论社区"三高"人群粗杂粮干预成本低,效果好,成本效果优势明显,值得进一步推广及长时间实施。

Objective To know the cost - effectiveness of coarse food grain intervention to people with hypertension, or/and hyperglycemia or/and hyperlipidemia （ ＂ three hyper - condition＂ ） who live in Gulou district of Nanjing in order to provide the strategy basis for whether the coarse food grain intervention is of value. Methods The ＂ three - hyper - condition＂ people living in 10 communities of Gulou district in Nanjing were given coarse food grain intervention. The physical examining data before and after the intervention were gained through regular physical examination. The cost - effectiveness evaluation of coarse food grain intervention was analyzed for patients with chronic diseases. Results Comparing the half year intervention group with the control group, the incremental cost - effectiveness ratios of systolic blood pressure （ SBP）, diastolic blood pressure （DBP） , fasting blood glucose （FBG） , total cholesterol （TC） , triglyeeride （TG） , high density lipoprotein -cholesterol （HDL- C ） were 18.11 （yuan/mm Hg）, 16.91 （yuan/mm Hg）, 110.32 [yuan/ （mmol/L）], 150.16 [yuan/ （mmol/L）], 107.77 [yuan/ （mmol/L）], and 280. 65 [yuan/ （mmol/L）] respectively. And comparing the one year intervention group with the half year intervention group, the incremental cost - effectiveness ratios of SBP, DBP, FBG, TC, TG, and HDL - C were 421.99 （yuan/mm Hg）, 272. 12 （ yuan/mm Hg）, 409. 79 [ yuan/ （mmol/L） ], 1 045.35 [ yuan/ （mmol/L） ], 782.93 [ yuan/ （mmol/L） ] , 2 762. 17 [ yuan/ （mmol/L） ]. Conclusion The coarse food grain intervention for the community ＂ three - by- per - condition＂ is lower in cost, good in effect, with a remarkable advantage of cost - effectiveness. It is worth further popularizing and long -lasting conducting.