2O11—2O15年新疆维吾尔自治区实施结核病防治规划的成本效益分析

The cost-benefit analysis on tuberculosis control and prevention in Xinjiang Uygur Autonomous Region in 2011-2015

目的评价新疆维吾尔自治区（以下简称“新疆”）2011—2015年实施《新疆维吾尔自治区结核病防治规划（2011-2015年》（以下简称“规划”）的成本效益。方法按照《全国结核病防治规划终期评估实施方案》，主要进行成本-效用比、效益-成本比来进行成本-效果的评价，收集新疆2011-2015年14个地、州（市）和94个县（市、区）规划评估表、结核病控制监测年报表和季报表，对2011-2015年新疆维吾尔自治区结核病防治规划实施的成本效益进行分析。结果2011-2015年，新疆共投入结核病防治经费18632．4万元，共发现活动性肺结核患者145229例，登记患者中因结核病死亡633例，涂阳患者治疗成功32725例，涂阴患者治疗成功92419例。累计减少因结核病死亡35675例，避免新感染385170例，避免新发患者38518例，节约医疗费用3774．8万元人民币，挽回的社会总价值1796933．2万元人民币。成本-效用比为246．6，效益-成本比为96．6。即每挽回1个伤残调整生命年（DALY）损失所需要的投入金额为246．6元人民币，每投入1元人民币结核病防治经费可产生96．6元人民币的社会经济效益；每成功治疗1例活动性肺结核患者所需要的社会成本为1488．9元。结论新疆实施结核病防治规划后，实现了高发现率和高治愈率的目标，取得了显著的社会效益和经济效益。

Objective To evaluate the cost-benefit on the implementation of Tuberculosis （TB） Control Programme in Xinjiang Uygur Autonomous Region from 2011-2015. Methods According to the final evaluation plan of the National TB Programme, using analytic methods of cost-utility ratio, cost-benefit ratio and cost-effect, the evaluation forms, annual and quarterly reports on TB control and surveillance in 14 prefectures and 94 counties of Xinjiang from 2011-2015 were collected to analyze the cost-benefit on the implementation of TB Control Programme in Xinjiang Uygur Autonomous Region from 2011-2015. Results 186. 324 million Yuan had been invested on TB in Xiniiang during 2011-2015. There were 145 229 active TB cases registered in Xinjiang, among whom 633 died of TB, there were 32 725 smear positive TB cases successfully cured, and 92 419 smear negative TB cases completed treatment. 35 675 TB cases avoided death clue to regular treatment, 385 170 people avoided being infected, 38 518 cases avoided TB, and 37. 748 million Yuan was saved in hospital expenditures, the social overall cost of about 17.97 billion Yuan was saved. The cost-utility ratio was 246.6, the cost-benefit ratio was 96.6. 246.6 Yuan was needed to save one disability-adjusted life year （DALY）, and one Yuan investment on TB produced 96.6 Yuan social and economic benefits. The social cost of curing an active TB patient was 1488. 9 YuarL Conclusion Through the implementation of the TB Control Programme in Xinjiang, the goals of high case detection rate and high cure rate have been achieved, as well as significant social and economic benefits.