摘要
目的:对助听器康复干预进行成本效果分析,并考虑将助听器纳入医疗保险后对医保预算的影响。方法:利用在山东省临沂市开展的助听器康复干预的随机对照试验,通过双重差分法进行增量成本效果分析,以年人均国内生产总值作为是否具有成本效果的阈值;其次进行预算影响分析,测算在不同助听器报销比例下的医保预算费用变动。结果:假设每副助听器的购买费用为10,000元,助听器的平均使用年限为n年,若n>2.20,则干预非常具有成本效果;若1.88<n<2.20,则干预增加的成本效果可以接受;若n<1.88,则干预措施不具有成本效果。若将助听器购买费用纳入医疗保险系统,最多约需3.25年医保预算即可持平。结论:助听器干预是一种具有成本效果的听力康复手段,且若将其纳入医保报销,长期来看可节约医保预算。因此,本研究建议完善与听力障碍康复相关的保障政策,如鼓励助听器技术的研发和创新、推动将助听器纳入医保报销等,从而促进听力治疗和康复干预。
Objective To analyze the cost-effectiveness of hearing aid rehabilitation intervention,and consider the impact of hearing aid inclusion on the health insurance budget.Methods Randomized controlled trial of hearing aid rehabilitation intervention was conducted in Linyi City,Shandong Province.The incremental cost-effectiveness analysis was carried out through the difference in difference method,and the annual per capita GDP was taken as the threshold of cost-effectiveness.The budget impact analysis was carried out to estimate the changes in the health insurance budget costs under different reimbursement ratios of hearing aids.Results Assuming the purchase cost of each pair of hearing aids is 10,000 yuan,if the average service life(n)of hearing aids is>2.20,then the intervention is very cost-effective.If 1.88<n<2.20,then the increased cost effect of intervention is acceptable.And if n<1.88,then the intervention is not cost-effective.If the cost of hearing aid purchase is included in the health insurance system,it will take about 3.25 years for the balanced health insurance budget.Conclusion The hearing aid intervention is a cost-effective means of hearing rehabilitation,and if covered by health insurance,it can save the budget in the long run.Therefore,it is suggested to improve the policies related to hearing impairment rehabilitation,such as encouraging the research and innovation of hearing aid technology,and promoting the inclusion of hearing aids in health insurance reimbursement,which can promote the hearing treatment and rehabilitation intervention.
作者
叶欣
朱大伟
陈思源
何平
Ye Xin(Institute for Global Public Policy,Fudan University,Shanghai,P.R.China)
出处
《中国卫生事业管理》
北大核心
2024年第7期759-764,共6页
Chinese Health Service Management
基金
国家社会科学基金重大项目“人口老龄化背景下的残疾预防策略与应用研究”(21&ZD187)
国家自然科学基金面上项目“社区康复干预对听力障碍老年人生命质量的影响及成本效果评价”(71874005)
国家卫生健康委员会卫生技术评估重点实验室2023~2024年度开放基金课题“听力障碍中老年人助听器康复干预的卫生经济学评价研究”。
关键词
助听器
干预
成本效果分析
预算影响评价
hearing aids
intervention
cost-effectiveness analysis
budget impact assessment
