2001～2010年潍坊市奎文区实施结核病控制规划的卫生经济学评价

Health Economics Evaluation on Implementation of Tuberculosis Control Planning in Kuiwen District,Weifang City,2001-2010

[目的]评价实施结核病控制规划和中央补助项目的社会经济效益,为制定结核病控制政策和策略提供科学依据。[方法]对2001～2010年潍坊市奎文区实施结核病控制和中央补助结核病控制项目的相关资料进行分析。[结果]2001～2010年累计登记活动性肺结核患者805例,其中新发涂阳病人437例,复治涂阳病人24例,新治涂阴病人329例,未痰检15例。活动性肺结核登记率由2001年的9.51/10万提高到2010年的33.30/10万,年均23.22/10万。其中新发涂阳登记率由2001年的5.52/10万提高到2010年的16.93/10万,年均12.61/10万。2001～2009年累计完成治疗活动性肺结核病人655例,完成治疗率为95.34%。其中新发涂阳患者治愈率为94.43%,复治涂阳患者治愈率为95.45%,涂阴和未查痰患者完成治疗率为96.53%。2001～2010年平均发现并治疗1例患者的政府投入为642元,发现并完成治疗1例患者的社会平均投入为7 131元;每挽回1个DALY损失的社会投入为402元;只考虑政府投入的成本-效益比为1∶189,计算患者住院费用的社会成本-效益比为1∶19.4。测算避免183例肺结核患者死亡,减少新发病人329例,每挽回1个DALY损失的社会投入为704元,只考虑政府投入的成本-效益比为1∶113,计算患者住院费用的社会成本-效益比为1∶11.6。[结论]2001～2010年奎文区肺结核防控效果明显,实施结核病控制规划和中央补助项目具有良好的成本效益/效用。

[Objective]To evaluate the social and economic benefits of implementing tuberculosis control planning and the central subsidy project,so as to provide scientific basis for making tuberculosis control policies and strategies. [Methods]The relevant data on implementation of tuberculosis control planning and central subsidy project for tuberculosis con trol were analyzed in Kuiwen district,Weifang city during 2001-2010. [Results]During 2001-2010, the accumulative regis trations of active tuberculosis patients were 805 cases,of which there were 437 cases of new smear positive patients,24 cases of re-treated smear positive patients, 329 cases of smear negative patients, and 15 patients bad no sputum inspec tion. The registration rate of active tuberculosis increased from 9.51/10^5 in 2001 to 33.30/10^5 in 2010 with annual average rate of 23.22/10^5. Among them,the registration rate of new smear positive tuberculosis increased from 5.52/105 in 2001 to 16.93/10^5 in 2010 with the annual average rate of 12.61/10^5. From 2001 to 2009,the accumulative completion of treatment active tuberculosis patients was 655 cases and the treatment completion rate was 95.34%. Among them,the cure rate of new smear positive patients was 94. 430/oo ,the cure rate of re-treated smear positive patients was 95.45% and the treat ment completion rate of smear negative patients and patients without sputum inspection was 96.53%. From 2001 2010,the government input to find out and cure one patient was 642 Yuan in average and the social average input to find out and cure one patient was 7 131 Yuan. The social input to save each DALY loss was 402 Yuan. With only consideration of government input, the cost-benefit ratio was 1 ： 189. With the hospitalization cost of patients being calculated,the social costbenefit ratio was I ： 19.4. Measurement can avoid the death of 183 tuberculosis patients and reduce 329 new tuberculosis patients. The social input to save each DALY loss was 704 Yuan. With only consideration of government input,the cost benefit ratio was 1 ： 113. With the hospitalization cost of patients being calculated,the social cost benefit ratio was 1 ： 11.6. [Conclusion]From 2001 to 2010 ,the prevention and control effects of tuberculosis in Kuiwen district are obvious and the implementation of tuberculosis control planning and central subsidy project leads to good cost efficiency/effectiveness.