基于成本分析的临床科研探索：学龄儿童不同近视筛查方法成本分析

Clinical exploration based on cost analysis： costs among different screening methods for myopia in school-aged children

为了探索一条有效的成本较低的，操作便捷且易于推广的早期近视检出方法。选择北京市羊坊店学区1427名6～12岁学龄儿童为研究对象，随机采用轴率比联合远视力和远视力筛查作为检出及转诊标准。依据成本核算公式，核算两种方法的筛查成本、转诊费用，计算确诊1例近视所需平均成本。结果提示采用轴率比联合远视力筛查较远视力筛查可以分别降低成本15．12％和12．34％。可见轴率比联合远视力进行筛查，在各年龄组中成本均低于远视力筛查，是一种经济合理的学龄儿童群体近视筛查方法。

To explore an easily executive and conveniently generalized method with effectiveness and low costing for myopia screening at the early stage. Research was performed to testify the reason- ability of using axial length/corneal radius （AL/CR） for myopia screening in children by comparing the cost between AL/CR plus vision acuity （VA） and simple VA examination. Chinese school-aged children in Yangfang school district, Beijing （n=1427, aged 6--12 years old） were randomly grouped for either pure VA examination or for VA plus AL/CR examination. Those suspicious myopic children were informed for further refractive examination. Finally, the cost from screening to definite diagnosis of refractive error was calculated. Generally, compared with VA examination, the total cost was re- duced by 15.12 % and by 12.340~ , respectively,in the elder group using VA plus AL/CR examina- tion. VA plus AL/CR examination is an economical and reasonable method for screening suspicious myopia in Chinese school-aged children compared with pure VA examination.