湖北省世行贷款/英国赠款结核病控制项目经济学评价

Economic evaluation of TB control project loaned by World Bank (WB) and UK's Department for International Development(DFID) in Hubei Province

目的从卫生经济学的角度评价湖北省世行贷款/英国赠款结核病控制项目,为结核病控制的可持续发展提供科学依据。方法收集2002～2007年湖北省项目资料,并通过问卷法进行补充,对项目进行成本—效果、成本—效用和成本—效益分析,分析项目直接、间接和潜在经济效益。结果2002～2007年发现活动性结核病人184694人,治愈173195人,项目共投入12540.2万元,发现并治愈1例活动性肺结核病人项目投入的平均费用为724元;共挽回1825302个伤残调整寿命年(DALY),避免1614525人免受结核菌的感染,减少新发病人193743例;挽回国内生产总值(GDP)和病人个人可支配收入为2027545万元和1788796万元;估计减少直接、间接和潜在经济损失分别为62342万元、74224万元、161465万元,总经济成本/效益比为1∶23.8。结论湖北省世行贷款/英国赠款结核病控制项目符合低投入、高产出的经济学原则,可操作性强,经济效益显著,是一项非常值得借鉴和推广的疾病控制项目。

Objective To analyze the heahh-economic benefit of Hubei WB/DFID TB control project from 2002 to 2007 and provide scientific basis for sustainable development of TB control in the future. Methods Data of Hubei WB/DFID TB control project was collected from Hubei CDC. In addition, questionnaires were used to collect some essential data. Three main health-economic techniques （EA, CUA, CBA） were adopted. Economic benefit was analyzed from the direct,indirect and potential ways. Results From 200：2 to 2007,184 694 active TB patients were found, 173 195 were cured. A total of RMB 185.55 million Yuan was invested in this project. The discover and cure cost of one patient on average was RMB 1 005 Yuan. DALY of 1 825 302 year was saved, 1 614 525 healthy people might be avoided contacting tubercle bacillus, thus reducing 193 743 TB cases. A loss of GDP RMB 20.275 45 billion Yuan was avoided, as well as a loss of Hubei province personal disposable income （ RMB 17. 887 96 billion Yuan）. The direct economic benefit of this project was RMB 623.42 million Yuan, the indirect, RMB 742.24 million Yuan,and the potential,RMB 1. 614 65 billion Yuan. The total economic cost/benefit ratio is 1： 16. 1. Conclusions In accordance with the low-input, high-output econom- ic principles, Hubei WB/DFID TB control project is a typical disease control example worthy to be learned and promoted with its high feasibility and significant economic benefit.