基于HIV防治成本测算工具的石家庄HIV综合防治干预成本测算

The Cost Estimation of HIV Comprehensive Prevention and Control InterventionBased on the 2015—2019 Data in Shijiazhuang

目的:测算河北省石家庄市2015—2019年度人类免疫缺陷病毒(HIV)综合干预覆盖和成本。方法:以Spectrum软件模型参数框架开发调查问卷,测算石家庄市HIV干预措施覆盖及成本。结果:以2019年石家庄市生产总值平减指数(GDP price deflator)为基准,对Spectrum测算的成本费用及其构成进行调整后显示,石家庄HIV相关综合干预总成本(除外母婴阻断)自2015年的0.96亿元上升至2019年的1.94亿元,累计成本投入达7.08亿元,人均HIV干预成本从9.13元上升至17.75元,预防和抗病毒治疗总成本投入比介于5.28~7.57之间。用于HIV防治相关的医疗性预防和治疗服务成本与一般人群、高危人群干预的成本投入比从2015年52.64上升至2019年60.47。项目城市对测算数据的准确性进行核对后表明,母婴阻断成本存在疑点。结论:采用结构化成本测算工具,对HIV综合防治成本进行系统测算具有重要的实践意义,测算结果可以为艾滋病防治决策、资源分配以及目标管理提供循证依据。HIV综合干预领域预防和治疗经费分配不平衡趋势,逐年明显。针对国内疫情特征,分析HIV领域资源配置效率,探寻更加高效的一般人群、高危人群、感染者的经费分配和干预组合,是亟待研究的问题。

Objective:To estimate the coverage and cost of the comprehensive HIV interventions in Shijiazhuang,Hebei Province from 2015 to 2019 by applying Spectrum.Methods:The questionnaire is developed with the parameter framework of Spectrum to estimate the coverage and cost of HIV intervention in Shijiazhuang.Results:2019 GDP price deflator is adopted to modify the projected cost.The total cost of HIV-related comprehensive intervention in Shijiazhuang,except PMTCT(prevention of mother-to child transmission),has increased from 96 million yuan in 2015 to 194 million yuan in 2019,with a cumulative cost investment of 708 million yuan and a per capita HIV intervention cost rising from 9.13 yuan to 17.75 yuan.The total cost-input ratios of prevention and antiviral treatment rage from 5.28 to 7.57.The cost ratio of medical prevention and treatment services for HIV to the general population and high-risk group prevention has increased from 52.64 in 2015 to 60.47 in 2019.The cost of PMTC.T needs a further investigation.Conclusion:There is practical significance to systematically estimate the cost of comprehensive HIV prevention and control by using the structured cost calculation tool,and the results can provide evidence-based basis for HIV prevention and control decision-making,resource allocation and target management.The unbalanced distribution of funds for prevention and treatment in the field of HIV comprehensive intervention is obvious year by year.According to the characteristics of HIV in China,it is urgent to analyze the efficiency of resource allocation in HIV field,and to explore more efficient allocation of funds and intervention combination for general population,high-risk groups and infected persons.