四川省凉山州预防艾滋病母婴传播的成本研究

Cost of preventing mother-to-child transmission of HIV in Liangshan prefecture, Sichuan province

目的研究凉山州预防艾滋病母婴传播成本。方法使用分层抽样方法,从凉山州17个市县按照艾滋病疫情高、中、低疫情县分别抽取2个县,共6个市县,在县妇计中心、疾病预防控制中心和人民医院开展2017年预防艾滋病母婴传播成本调查,在2个高疫情县开展艾滋病病毒(HIV)阳性产妇个人成本调查,按照筹资渠道和可追溯性进行分析。结果 2017年凉山州6个县的预防艾滋病母婴传播成本总计770.44万元。从筹资渠道分析,中央财政经费占63.45%、个人费用占18.26%、机构经费占11.96%。从成本可追溯性分析,直接医疗成本占47.50%、直接非医疗成本占46.80%、间接成本占5.70%。结论凉山州预防艾滋病母婴传播成本以中央财政为主,直接医疗费用支出比例较高,个人成本占有一定比例。建议拓宽筹资渠道,增加地方政府投入、积极获得慈善机构等非政府组织支持。

Objective To study the cost of prevention of mother-to-child transmission of HIV(PMTCT) in Liangshan prefecture. Methods The stratified sampling method was used to select the samples from a total of 6 counties out of 17 counties in the prefecture in accordance with the high, medium and low AIDS epidemic, where the cost of PMTCT of Maternal and Child Health Care Institutes, Centers for Disease Control and Prevention, and general hospitals was collected in 2017, and the pregnant woman expenses of PMTCT was collected in the 2 high-epidemic counties. Then the cost was analyzed on the basis of funding channels and traceability. Results In 2017, the total cost of PMTCT in 6 counties was 7.744 million CNY. Based on the financing channel analysis, the central government spending accounted for 63.45%, personal spending for 18.26%, and institutional spending for 11.96%. Based on the cost traceability analysis,direct medical costs accounted for 47.50%, direct non-medical costs for 46.80%, and indirect costs for 5.70%.Conclusion The cost of PMTCT in Liangshan is mainly financed by the central government, with a high proportion of direct medical expenses, and a certain proportion of the personal costs. It is suggested to expand financing channels,increase input from the local governments, and actively obtain support from the charities and other non-governmental organizations.