不同模式下应用手机软件筛查新生儿高胆红素血症成本效益分析

Cost-Benefit Analysis of Screening for Neonatal Hyperbilirubinemia Using Mobile Phone Application in Different Modes

目的比较两种管理模式下新生儿家长使用手机应用软件(application,App)监测新生儿黄疸的成本效益,为推广使用手机App筛查高胆红素血症提供科学依据。方法于2017年9月—2018年9月在海南省澄迈县和万宁市年分娩量相近的两家医院各选取502名新生儿家长分为实验组和对照组,采用现场试验的研究方法在不同模式下应用手机App进行新生儿高胆红素血症筛查。实验组采用“医生-家庭联动模式”,对照组采用“家庭全自助筛查模式”,对两组家长进行问卷调查,并通过手机App后台对其30天内使用手机App监测新生儿黄疸情况进行监测并随访。结果实验组App注册率为82.47%,高于对照组(44.42%,P<0.001);对照组高危检出率为39.01%,高于实验组(29.95%,P<0.05);对照组高危检出就诊率为12.64%,高于实验组(3.23%,P<0.01)。实验组的成本效益比(1∶18.76)优于对照组(1∶13.22)。结论采用手机App监测新生儿黄疸水平具有较好的效益,且“医生-家庭联动模式”筛查成本效益比优于“家庭全自助筛查模式”,可将“医生-家庭联动模式”推广应用于新生儿访视范畴。

Objective To compare the cost-benefit of mobile phone application(App)for monitoring neonatal jaundice under two different management modes,so as to provide scientific basis for promoting the use of the mobile App in screening neonatal hyperbilirubinemia.Methods From September 2017 to September 2018,502 parents of newborns were selected from each two hospitals with similar annual delivery volume in Chengmai and Wanning of Hainan Province,respectively,and divided into the experimental group and the control group.The research method of field trial was adopted to conduct the screening of neonatal hyperbilirubinemia by using mobile phone APP in different modes.The experimental group adopted the doctor-family joint screening mode,while the control group adopted the family self-help screening mode.Then we conducted a questionnaire survey among parents of the two groups,and the situation they used mobile App to screen neonatal jaundice within 30 days was monitored and followed-up by backstage data.Results The App registration rate of the experimental group was 82.47%,which was higher than the control group(44.42%,P<0.001).In the control group,the high-risk detection rate and the consultancy rate of high-risk detection were 39.01%and 12.64%,respectively,which were better than 29.95%and 3.23%of the experimental group(P<0.05,P<0.01).Moreover,the cost-benefit ratio of the experimental group(1∶18.76)was higher than that of the control group(1∶13.22).Conclusion Mobile App has a good benefit in monitoring neonatal jaundice level.In terms of cost-benefit,the doctor-family joint screening mode is superior to the family self-help screening mode and can be widely used in neonatal health care.