甘肃省和政县农村老年性白内障防盲项目的卫生经济学评价研究

Health economics evaluation study of senile cataract blindness prevention project in Hezheng County,Gansu

目的对2014-2016年在甘肃省和政县开展的白内障综合防盲干预项目进行卫生经济学评价。设计横断面调查。研究对象甘肃省和政县2014-2016年老年性白内障手术前407例患者及术后半年109例患者。方法对所有调查对象进行卫生经济学问卷调查。通过净效益法、成本效益分析法和成本效果分析法评价项目产生的经济效益和总成本。主要指标直接成本、间接成本、直接经济效益、间接经济效益、总成本、总效益、净效益、成本效益比、成本效果比。结果2014-2016年项目期间甘肃省和政县白内障所致总体疾病经济负担为2142.28万元。白内障手术产生的总效益为3398424.98元,总成本为2939125.20元,净效益为459299.78元,效益成本比为1.16:1。项目每投入1万元可降低50岁以上白内障患者导致的0.027%的致盲率和0.164%致残率;项目每降低1%的50岁以上白内障患者的盲率,需投入36.47万元;每降低1%50岁以上白内障患者的残率,需投入6.11万元。结论在甘肃省和政县开展的老年性白内障防盲综合干预项目具有较好的产出回报比和较高的防盲技术效率。

Objective To conduct economic evaluation on the senile cataract blindness prevention project in Hezheng County of Gansu Province in 2014-2016.Design Cross-sectional study.Participants 407 senile cataract patients and 109 cataract patients received sight restoration surgeries between 2014 and 2016 in Hezheng County of Gansu Province.Method Questionnaires were distributed to all study objects and to evaluate the efficiency of the project through the method of net benefit analysis,cost benefit analysis and cost effectiveness analysis by measuring total economics benefit and cost.Main Outcome Measures direct cost,indirect cost,direct economic benefit,indirect economic benefit,total cost,total economic benefit,net benefit,cost benefit ratio,cost effectiveness ratio.Results Total economic burden caused by senile cataract in Hezheng of Gansu is 21.42 million Yuan.Total economic benefit inferred from senile cataract surgeries in the project from year 2014 to 2016 is 3398424.98 Yuan,total cost is 2939125.20 Yuan,the net benefit is 459299.78 Yuan,and the benefit cost ratio is 1.16:1.The results indicate that every invest of 10 million Yuan of the project can reduce the blindness rate of 0.027% and disability rate of 0.164% caused by senile cataract.The ratio of total cost and change of blindness rate incurred from senile cataract blindness prevention project is 36.47.The ratio of total cost and change of disability rate incurred from senile cataract blindness prevention project is 6.11.The results indicate that 364.7 thousand Yuan is needed to invest to reduce every 1% of blindness rate caused by cataract,and 61.1 thousand Yuan is needed to invest to reduce every 1% of disability rate caused by cataract.Conclusions The comprehensive cataract blindness prevention project in Hezheng of Gansu province has better return on investment and technical efficiency.