我国职业病报告工作的成本-效益分析

A cost-benefit analysis of occupational disease reporting in China

目的 对我国职业病报告制度进行成本-效益分析,为有效配置资源提供依据.方法 从《2013中国卫生统计年鉴》收集我国职业病报告成本相关资料,效益的估算资料来源于国内外公开发表的文献,概率设定资料来源于1986至2014年卫生计生行政部门发布的职业病发病情况通报.利用决策树方法进行成本-效益分析.结果 估算职业病报告的成本为10 247万元/年,其中全国医疗机构报告成本125万元/年、管理成本3 035万元/年,地方公共卫生机构管理成本6 980万元/年,国家公共卫生机构管理成本37万元/年,上报系统建设维护成本70万元/年.决策树分析结果显示,建立职业病监测系统,职业病监测和防治的增量投入共计为21亿元/年,产出为65亿元/年,建设职业病报告系统的收益为44亿元/年.结论 职业病报告制度的收益取决于职业病防控举措的成本收益,防控举措得当对于提高职业病报告制度效益至关重要.

Objective To perform a cost-benefit analysis of the occupational disease reporting system in China,and to provide a basis for effective resource allocation.Methods The data on the cost of occupational diseases were collected from China Health Statistics Yearbook 2013,the estimated benefit data were collected from published articles in China and foreign countries,and the probability data were collected from the occupational diseasereports published by health and family planning administrative departments.Adecision-making tree was used for the cost-benefit analysis.Results The estimated cost of occupational disease reporting was about 102.47 million yuan/year,consisting of a cost of reporting in national medical institutions of 1.25 million yuan/year,a management cost of 30.35 million yuan/year,a management cost in local public health institutions of 69.80 million yuan/year,a management cost in national public health institutions of 370 thousand yuan/year,and a cost of construction and maintenance of reporting system of 700 thousand yuan/year.The results of the decision tree analysis showed that when an occupational disease monitoring system was established,the incremental input for occupational disease monitoring and prevention/control was 2.1 billion yuan/year,the output was 6.5 billion yuan/year,and the benefit of occupational disease reporting system was 4.4 billion yuan/year.Conclusion The benefit of occupational disease reporting system depends on the cost-benefit of occupational disease prevention and control measures,and proper prevention and control measures are extremely important for improving the benefit of occupational disease reporting system.