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1992 1997年北京房山区心血管病社区人群干预的成本效果分析 |
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黄广勇 顾东风 吴锡桂 段秀芳 徐希胜 武杰 谢宝元
摘 要：目的 进行心血管病社区人群干预的成本效果分析。方法 以北京房山区心血管病综合防治研究为依托，计算1992～1997年的干预成本和干预区节省的心血管病费用，以失能调整生命年作为效果指标进行成本效果分析。结果 1992～1997年，每挽回一个生命年所需人民币分别为1 586.00、1 380.20、-2 350.80、-905.30、-1 495.60和-1 766.70元，随干预时间的延长，干预区每挽回一个生命年所需要的成本越来越少，干预2年后，成本效果比变为负值，即干预措施出现正效益。1992～1997年，总的效益比约为4∶1，即每投入1元人民币，节省心血管病费用4元人民币。灵敏度分析显示，成本效果比对贴现率、年龄权重参数和脑卒中、冠心病住院费用年增长率的敏感性较小，成本效果分析的结论可靠。结论 对农村社区人群进行心血管病综合干预可明显节省心血管病费用并且有较好的效益比。
关键词：心血管疾病；成本及成本分析；干预性研究
Cost-effectiveness analysis of Beijing Fangshan cardiovascular prevention program in 1992-1997
HUANG Guangyong, GU Dongfeng, WU Xigui, et al.
(Cardiovascular Disease Institute, Fu Wai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100037, China)
Abstract：Objective To determine whether a community-based cardiovascular disease (CVD) intervention program, undertaken over six years, was cost-effective. Methods Based on Beijing Fangshan Cardiovascular Disease Comprehensive Prevention Program, the cost for intervention and expenditure saved from caring for CVD in the communities with intervention from 1992 to 1997 were calculated, and cost-effectiveness analysis was performed using disability-adjusted life years (DALYs) gained as an indicator of effectiveness. Results The cost for one DALY gained reduced gradually from 1992 to 1997，with an average ratio of cost to effectiveness of four to one (4∶1). It cost annually 1 586.00, 1 380.20, -2 350.80, -905.30, -1 495.60 and -1 766.70 RMB yuan for one life-year saved，from 1992 to 1997 respectively, in a gradually decreasing trend with the increase in length of intervention. After intervention for two years, ratio of cost to effectiveness has become negative since 1994, which meant a positive benefit from intervention. Sensitivity analysis showed that ratio of cost to effectiveness was little sensitive to the changes in discount rate, weight of age and increase in cost of hosp[1] [2] 下一页
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