Dairy heifers only start to produce a return on investment at first calving. The length of the non-productive rearing period is largely governed by farmer decisions on plane of nutrition and reproduction management. P...Dairy heifers only start to produce a return on investment at first calving. The length of the non-productive rearing period is largely governed by farmer decisions on plane of nutrition and reproduction management. Primary data were collected from 101 dairy farms and a cost analysis workbook developed to calculate individual inputs in each of three periods to determine which management decisions and farm factors have the greatest influence on the total costs associated with rearing. This paper covers weaning until conception. Heifers were weaned at 62 d (range 42 - 112 d) and conceived by 509 d (range 365 - 700 d) giving an average weaning to conception period of 447 ± 60 d (range 253 to 630 d). The mean daily cost of rearing during this period was ￡1.65 (range ￡0.75 to ￡2.97 on different farms) giving a mean total cost of ￡745.94 per heifer (range ￡295.32 to ￡1745.85). This large variation was mostly due to the duration, which was mainly determined by age at first breeding (mean 476 days, range 365 - 700 d). The main contributors to total costs were feed (35.6%), labour (24.7%) and bedding (8.9%). The variables most strongly associated with the total costs were age at conception, calving pattern and breed. A multivariable model predicted an increase in mean cost of ￡2.26 for each extra day in age at conception. The total cost was highest in herds with all year round calving, intermediate in multi-block and lowest in spring and autumn calving herds, with Friesian x and Jersey herds having the lowest cost of rearing.展开更多
目的分析2016—2018年北京市石景山区在男男同性性行为人群(men who have sex with men, MSM)中开展国家社会组织参与艾滋病防治基金(简称防艾基金)的效果,并从经济学角度进行成本效果分析,为继续开展防艾基金项目提供依据和建议。方法...目的分析2016—2018年北京市石景山区在男男同性性行为人群(men who have sex with men, MSM)中开展国家社会组织参与艾滋病防治基金(简称防艾基金)的效果,并从经济学角度进行成本效果分析,为继续开展防艾基金项目提供依据和建议。方法建立项目组和对照组Markov模型,收集相关成本和转移概率参数,模拟30年后项目组和对照组的成本和获得的质量调整寿命年(quality-adjusted life year, QALY),计算项目开展的成本效果。结果北京市石景山区2016—2018年在MSM中开展防艾基金项目总投入1 710 163元,发现人类免疫缺陷病毒(human immunodeficiency virus, HIV)感染者和艾滋病(acquired immunodeficiency syndrome, AIDS)患者215例,阳性平均检出成本为7 954.25元/例。与对照组相比,干预组每挽救1个QALY的增量成本效果(incremental cost effectiveness ratio, ICER)为961.44元,小于2016年北京市人均GDP11.82万元。结论北京市石景山区在MSM中开展防艾基金项目成本效果好,值得继续开展。展开更多
目的分析珠海市MSM中HIV自我检测(HIVST)模式和现场HIV快速检测(HIV-RDT)模式的成本效果和支付意愿,为政府合理配置卫生资源提供参考依据。方法以卫生服务提供者的视角,收集珠海市在2019年1-9月MSM参与两种HIV检测模式的成本投入和效果...目的分析珠海市MSM中HIV自我检测(HIVST)模式和现场HIV快速检测(HIV-RDT)模式的成本效果和支付意愿,为政府合理配置卫生资源提供参考依据。方法以卫生服务提供者的视角,收集珠海市在2019年1-9月MSM参与两种HIV检测模式的成本投入和效果产出,采用TreeAge Pro 2019软件构建10000名MSM队列决策树模型,测算成本效果比(CER)和增量成本效果比(ICER),以敏感性分析模型中各参数的不确定性,绘制成本效果可支付曲线评价策略的可支付性。结果珠海市男同社会组织通过互联网+社交媒体动员参与HIVST和现场HIV-RDT的MSM人次数为2303 vs.816,发现HIV筛查阳性者人数为33 vs.35,筛查阳性率为1.7%vs.4.3%。每筛查1例的成本为60.45元vs.240.43元,每发现1例筛查阳性的成本为4218元vs.5606元。决策树模型运行结果显示,每检测1例MSM的平均费用为44.67元vs.148.42元,ICER为负值。当发现1例HIV筛查阳性支付意愿低于6528元时,HIVST更具成本效果的选择;当投入高于该阈值时,现场HIV-RDT是更具成本效果的选择。结论珠海市现行的HIVST模式是具有经济学价值的公共卫生项目,决策者应加大社会组织扶持力度,推广HIVST在MSM中的应用。展开更多
文摘Dairy heifers only start to produce a return on investment at first calving. The length of the non-productive rearing period is largely governed by farmer decisions on plane of nutrition and reproduction management. Primary data were collected from 101 dairy farms and a cost analysis workbook developed to calculate individual inputs in each of three periods to determine which management decisions and farm factors have the greatest influence on the total costs associated with rearing. This paper covers weaning until conception. Heifers were weaned at 62 d (range 42 - 112 d) and conceived by 509 d (range 365 - 700 d) giving an average weaning to conception period of 447 ± 60 d (range 253 to 630 d). The mean daily cost of rearing during this period was ￡1.65 (range ￡0.75 to ￡2.97 on different farms) giving a mean total cost of ￡745.94 per heifer (range ￡295.32 to ￡1745.85). This large variation was mostly due to the duration, which was mainly determined by age at first breeding (mean 476 days, range 365 - 700 d). The main contributors to total costs were feed (35.6%), labour (24.7%) and bedding (8.9%). The variables most strongly associated with the total costs were age at conception, calving pattern and breed. A multivariable model predicted an increase in mean cost of ￡2.26 for each extra day in age at conception. The total cost was highest in herds with all year round calving, intermediate in multi-block and lowest in spring and autumn calving herds, with Friesian x and Jersey herds having the lowest cost of rearing.
文摘目的对2017—2020年北京市开展的男男性行为者"互联网+"尿液人类免疫缺陷病毒(human immunodeficiency virus,HIV)抗体传递检测模式进行成本效果分析。方法从社会投入的角度测算2017—2020年男男性行为者"互联网+"尿液HIV抗体传递检测模式的成本投入,并收集检测数和检出的新发现HIV确证阳性数等指标;采用Markov模型模拟所有HIV阳性者30年后所能获得的总的质量调整生命年(quality-adjusted life year,QALY);最后进行成本效果分析。结果2017—2020年北京市互联网+尿液HIV抗体传递检测各年的总成本呈现先升高后下降的趋势,其中,2017年最低为31.428万元,而2018年最高为67.993万元,2019和2020年分别为62.478和36.487万元;4年间共发放尿液采样服务包13399份,回收9938份,新发现HIV确证阳性者163例,单位检测成本为100.62元,每新发现1例HIV确证阳性者成本为1.217万元。Markov模型模拟结果显示,每新发现1名HIV确证阳性者可以累积获得16.045个QALY,每挽回1个QALY需要0.078万元。结论北京市开展的男男性行为者"互联网+"尿液HIV抗体传递检测模式符合成本效益原则,建议作为常规HIV检测的补充进行推广。
文摘目的分析2016—2018年北京市石景山区在男男同性性行为人群(men who have sex with men, MSM)中开展国家社会组织参与艾滋病防治基金(简称防艾基金)的效果,并从经济学角度进行成本效果分析,为继续开展防艾基金项目提供依据和建议。方法建立项目组和对照组Markov模型,收集相关成本和转移概率参数,模拟30年后项目组和对照组的成本和获得的质量调整寿命年(quality-adjusted life year, QALY),计算项目开展的成本效果。结果北京市石景山区2016—2018年在MSM中开展防艾基金项目总投入1 710 163元,发现人类免疫缺陷病毒(human immunodeficiency virus, HIV)感染者和艾滋病(acquired immunodeficiency syndrome, AIDS)患者215例,阳性平均检出成本为7 954.25元/例。与对照组相比,干预组每挽救1个QALY的增量成本效果(incremental cost effectiveness ratio, ICER)为961.44元,小于2016年北京市人均GDP11.82万元。结论北京市石景山区在MSM中开展防艾基金项目成本效果好,值得继续开展。
文摘目的分析珠海市MSM中HIV自我检测(HIVST)模式和现场HIV快速检测(HIV-RDT)模式的成本效果和支付意愿,为政府合理配置卫生资源提供参考依据。方法以卫生服务提供者的视角,收集珠海市在2019年1-9月MSM参与两种HIV检测模式的成本投入和效果产出,采用TreeAge Pro 2019软件构建10000名MSM队列决策树模型,测算成本效果比(CER)和增量成本效果比(ICER),以敏感性分析模型中各参数的不确定性,绘制成本效果可支付曲线评价策略的可支付性。结果珠海市男同社会组织通过互联网+社交媒体动员参与HIVST和现场HIV-RDT的MSM人次数为2303 vs.816,发现HIV筛查阳性者人数为33 vs.35,筛查阳性率为1.7%vs.4.3%。每筛查1例的成本为60.45元vs.240.43元,每发现1例筛查阳性的成本为4218元vs.5606元。决策树模型运行结果显示,每检测1例MSM的平均费用为44.67元vs.148.42元,ICER为负值。当发现1例HIV筛查阳性支付意愿低于6528元时,HIVST更具成本效果的选择;当投入高于该阈值时,现场HIV-RDT是更具成本效果的选择。结论珠海市现行的HIVST模式是具有经济学价值的公共卫生项目,决策者应加大社会组织扶持力度,推广HIVST在MSM中的应用。
