2011—2019年中国结核病防治工作经费投入与效益产出分析

Analysis on funding input and benefit output for tuberculosis control and prevention in China from 2011 to 2019

目的探讨2011—2019年我国结核病防治工作经费投入所产生的社会效益。方法收集中国《结核病信息管理系统》中2011—2019年涂阳肺结核(包括初治涂阳和复治涂阳)患者成功治疗和肺结核患者劳动力人口比例,历年地方结核病专项经费投入专题调查和结核病预防控制中心的社会成本等数据(包括中央转移支付重大公共卫生结核病项目、基本公共卫生项目和国际项目投入经费的数据),以及我国人均国内生产总值(gross domestic product,GDP)等相关数据。采用成本-效果、成本-效用和成本-效益等常用卫生经济学方法评估2011—2019年我国结核病防治经费投入的社会效果、社会效用和社会成本。结果 2011—2019年,社会投入用于我国结核病防治工作的各种资源共计约164.5亿元,通过成功治疗247.3万例涂阳肺结核患者,使1854.4(1112.7~2781.6)万名健康人免受传染,为社会节约了74.2(44.5~111.3)亿元的医疗费用支出,共挽回了7145.7亿元的社会经济损失。在现有人员和设施设备基础上,政府每额外投入1元,即可产生43.9(43.7~44.1)元的经济效益;每投入886.9(591.3~1478.0)元,即可避免1名健康人被传染;每投入933.5元,即可挽回1个伤残调整生命年(disability adjusted life year,DALY)损失。结论 2011—2019年,我国各级政府及国际项目对结核病防治工作的经费投入具有较高的卫生经济学效益。建议各级政府继续加大对结核病防治工作的投入,以期获得可持续的社会效益。

Objective To explore the social benefit generated by the funding for tuberculosis(TB)control and prevention from 2011 to 2019. Methods The data of smear positive TB patients treatment outcome and proportion of TB labor population from 2011 to 2019 were collected from the National Tuberculosis Information Management System,and funds input of the government(including local and central government),international projects,and relevant data such as per capita GDP from 2011—2019 were collected as well.The most common methods in health economics such as cost-effectiveness,cost-utility,cost-benefit were applied to assess TB control social effect,social utility and social cost during 2011-2019. Results The total of 16.45 billion yuan of a variety of resources was invested during the year of 2011-2019,2.473 million smear positive TB patients were treated successfully,18.544(11.127-27.816)million healthy people were protected from infection and 7.42(4.45-11.13)billion yuan of medical expenses were saved,714.57 billion yuan of social and economic losses were recovered.On the basis of current staff and facilities,every additional input of government with 1 yuan produced43.9(43.7-44.1)yuan economic benefits.It cost only 886.9(591.3-1478.0)yuan for each healthy person to avoid infection.Only 933.5 yuan was needed to save the loss of a DALY. Conclusion From 2011 to 2019,the investment of governments and international projects in TB prevention and control has high health and economic benefits.It is suggested that governments at all levels continue to increase investment in TB prevention and control in order to achieve sustainable social benefits.