中国计划免疫四病控制的经济效益估计(1950～1998)

The Estimation of Economic Benefit on EPI Target 4 Disease Control in China(1950～1998)

[目的 ]估计我国 195 0～ 1998年计划免疫 (EPI)四病 (脊灰、麻疹、白喉和百日咳 )的发病趋势和计免开展所获得的经济效益。 [方法 ]收集全国疫情 ,以 SPSS软件包建立数据库 ,以计免前年发病“中位数法”与“指数平滑法”预测计免后 17年 (1982～ 1998)每年减少的发病例数。每个病例的经济损失分别以 10 0 0、40 0、6 0 0和 2 0 0元估计 ,未考虑减少发病损失 (经济效益 )的时间贴现。 [结果 ]计免前 32年 (195 0～ 1981)合计四病发病中位数为每年约 436万例 ;计免以来的17年 (1982～ 1998)累计四病减少发病约 6 85 4万例 (指数平滑法为 472 2万例 )。估计所获经济效益达 2 40亿元 (指数平滑法为 173亿元 )。 [结论 ]49年来四病下降趋势与计免工作的开展 ,表明计免投资是一项花钱少、效益高的健康投资 ,其费用效益比 >1∶ 14(指数平滑法约为 1∶ 10 )

Objective] To estimate the economic benefit of EPI target 4 disease control (polio, measles, diphtheria and pertussis, 1950～1998) and analyze the incidence curve.[Method] Collecting the disease data every year nationally, using SPSS 9.0 for Windows to calculate the median number of cases before EPI (1950～1981). The economic loss of each case is estimated by 1 000, 400, 600 and 200 Yuan RMB respectively. [Results] The median of 4 diseases before EPI is 4.36 million; For recent 17 years of running EPI (1982～1998), the cumulative reduced cases of the diseases are about 68.54 million. The reduced economic loss reaches to 24 000 million Yuan. When using EXSMOOTH method in SPSS, it reaches to 17310 million Yuan. [Conclusion] EPI is a high benefit health investment for public health and the ratio of cost benefit (CBA) is about 1∶14 or higher. If using the method of EXSMOOTH, the CBA is about 1∶10.