艾滋病低流行地区结核病人中HIV感染筛查卫生经济学评价

Health economics evaluation of HIV screening among TB patients in low prevalence areas of HIV/AIDS

目的评估艾滋病低流行地区结核病人中HIV感染筛查卫生经济学可行性,为TB/HIV双重感染干预策略制定提供依据。方法采用卫生经济学的成本-成果分析、成本-效益分析和成本效用分析进行估算,估算在艾滋病低流行地区开展筛查后产生的效果、效益及效用。结果江西省男性期望寿命是70.57岁,女性是75岁,成本效果分析显示在艾滋病低流行地区每例多花费96 486元,可以延长患者生存年限6年以上;成本效益显示筛查总成本是2 086 737.5元,效益为4 015 874.25元,成本效益比为1:1.92。成本效用分析显示开展筛查地区每例TB/HIV双重感染者损失17个DALY,在艾滋病低流行地区每挽回1个DALY需要多投入18 999元。结论艾滋病低流行地区开展HIV感染筛查干预是可行的,具有社会、经济学效益,尤其值得在HIV高疫情地区推广。

Objective To assess the feasibility of implementing HIV infection screening among tuberculosis patients in lowAIDS prevalence regions on health economics, to provide basis for TB/HIV infection intervention strategies.MethodsThecost-effectiveness analysis, cost-benefit analysis and cost-utility analysis of health economics were adopted to estimate theeffectiveness, benefits and utilities of HIV screening in low AIDS prevalence regions.ResultsThe life expectancy of maleis 70.57 years, and that of female is 75 years in the population in Jiangxi province. The outcome of cost-effectivenessresearch suggested that additional 96 486 Yuan spending in each HIV patient could prolong the survival period over 6years; Cost-benefit analysis indicated that the total screening cost and benefit are 2 086 737.5 Yuan and 4 015 874.25 Yuan respectively. The cost/benefit ratio is 1：1.92. Cost-utility analysis showed that the lost of each case of TB/HIVdouble infection is 17 DALY and saving one DALY need to invest 18 999 Yuan in low AIDS prevalence regions.ConclusionIt＇s feasible to implement HIV infection screening in low AIDS prevalence areas with significantly social andeconomic benefits, especially in the regions with high AIDS prevalence.