美沙酮维持治疗与强制戒毒的成本效益比较

The cost benefit analysis between methadone maintenance treatment and compulsory detoxification

目的:比较分析美沙酮维持治疗与强制戒毒的投入与产出。方法:通过对8家美沙酮维持治疗门诊(简称"门诊")以及3家强制戒毒所(简称"强戒所")的问卷调查和定性访谈,运用投入产出的分析方法进行评价。结果:无论是总成本还是例均成本,3个强戒所均高于当地美沙酮门诊;在降低吸毒量方面,门诊和强戒所的效益/成本比值分别为8∶1～26∶1和6∶1～20∶1;在恢复病人重返工作岗位等社会功能方面,美沙酮维持治疗工作具有一定的社会经济效益。建议:在吸毒人员较多且艾滋病相对高流行的地区,积极开展社区美沙酮维持治疗,是控制吸毒人员艾滋病流行的一种有效的行为干预方法;美沙酮维持治疗和强制戒毒具有相互促进、互为补充的作用。

Objectives： This study is focusing on the cost-benefit analysis on methadone maintenace treatment project and compulsory detoxification work. Methods： Based on the questionnaire survey and interview designed according to the investigation on the cost and treatment effects of eight clinics for methadone maintenace treatment （clinics for short） and three compulsory detoxification centers, the study uses the method and theory of health economics to make an analysis. Results： All the costs of the three compulsory detoxification centers, whether the total costs or the costs per person-time, are higher than those of the clinics located in the same districts. In the aspect of decreasing drug use amount, the cost-benefit ratios of the eight clinics are fluctuating between 8：1 and 26：1 ; the cost-benefit ratios of the three compulsory detoxification ceters are fluctuating between 6：1 and 20： 1. In the aspect of the patient obtaining employment again after treating for a period, the methadone maintenace treatment project has social and economic benefits to some extent. Suggestions： Actively developing methadone maintenance treatment in the areas with high HIV infection rate is one way of the effective behavior interventions controlling drug abuse and managing drug users. The function of methadone maintenance treatment and compulsory detoxification is mutual promotion and complementory each other.