四川省结核病控制项目社会经济学评价

Socieal Economics Evaluation on the World Bank Loan TB Control Project in Sichuan Province

目的 从社会经济学角度评价四川省世界银行贷款病控制项目的效益与效果。方法 采用社会效益评价、成本—效果分析、成本—效益分析方法。结果 ①项目期间保护了 160万～ 2 40万健康人不受结核菌感染 ,少发生结核患者 16万～ 2 4万例 ;② 2 0 0 0年肺结核患病率、涂阳患病率、菌阳患病率、死亡率分别较 1990年下降 41 8%、 3 5 0 %、3 0 0 %和 12 0 % ;③项目期间治愈传染性患者 14 3 470例 ,为国家节约卫生资源 4 0 8亿元。④治愈肺结核患者每年为国家创造经济效益 6 0 6亿元 ;⑤成本效益比值为 1∶42。⑥结论 项目实施使四川省结核病疫情明显下降 ,项目单位的患者发现、治疗、管理等费用远低于综合医疗机构 ,节约了大量卫生资源 ,治愈的肺结核患者重新投入生产工作岗位 ,为国家创造了巨大的财富 ,是符合成本—效益、成本—效果原则的结核病控制策略。

Objective To evaluate the benefit and effect of the world bank loan TB control project from the point of social economics view Methods The mathods of social benetit evaluation,Cost effect analysis,and cost benefit analysis were adopted Results In the implementation of the project 1 6～2 4 millions health people avoided contractine tubercle bacillus thus reducing 160000～240000 TB cases (2)Compared with epidemic condition of TB in 1990,the prevalence rate of mobile TB,of positive bacteria,and of positive smear ,and the death rate have declined by 41 8%,30 0%,35 0%,and 12 0% respectively in 2000 (3) There were 143470 infectious patients cured in implementing the project which saved health resources 408 millions yuan RMB for our country (4)These patients who have been cured create econmy benefit 606 millions yuan RMB every year (5)The ratio of cost to benefit is 1∶42 Conclusions The epidemic condition of TB have evidently declined by implementing the project The expense of finding, treating and managing patient is less in project unit than that in general medical treatment agencies There are vast health resource saved These patient who have been cured create large forfuns for country by going back to work again It is a TB control policy that accords with cost benefit and cost effect principles