初治涂阳肺结核病人DOTS及非DOTS干预的成本-效果分析

Cost-effectiveness of DOTS and non-DOTS strategy for smear-positive pulmonary tuberculosis

目的 评价初治涂阳肺结核病人DOTS及非DOTS干预的成本 -效果。方法 以初治涂阳肺结核病人用于药品、痰涂片、痰培养及X线检查四个部分的支出构成成本 ;干预的效果包括直接与间接效果两部分 :一是治愈病人而减少的DALY损失 ,二是降低传染而减少的DALY损失。结果 DOTS干预的病人以 4 5 7元即可挽救一个寿命年 ,而非DOTS干预的病人则需要 4 71 .3元才能挽救一个寿命年。结论 DOTS是费用 -效果佳的结核病控制策略。

Objective The study is to evaluate cost effetiveness of DOTS and non-DOTS strategy for smear-positive pulmonary tuberculosis.Methods Cost accouting based on the expenses for drugs,chest X-ray films,sputum smears and cultures for the patients.Effectiveness of intervention was composed of two aspects:direct benefits to the patient treated,and indirect benefits to others though reduced transmission of tuberculosis,and DALY is the index.Results One DALY could be saved with 45.7 yuan by DOTS and 471.4 yuan by non-DOTS.Conclusion DOTS is a good cost-effectiveness stratcgy for TB control.