大理白族自治州结核病防治规划实施绩效卫生经济学评估报告

摘要

Objective: To evaluate the Health Economic Effects of “the TB control planning during 2002—2010 in Autonomous Prefecture of Dali”, to provide some scientific suggestions to the plan of control and allocation of health resources. Methods:Collecting the data of TB prevention and control during the planning period, inspecting the data according to the information management system of the TB, and using the statistical analysis of the cost-effectiveness. Results:17 750 TB cases, including 9 786 TB infectious cases, were found and treated during 2002—2010 in Autonomous Prefecture of Dali. 181.90% of the planning objectives were completed. The cure rate is 91.36%, which is better than the planning target for 6.36%. 4 301TB dead cases were reduced, avoiding 70 577 new infections cases, and refraining from 7 058 new cases.92 701 DALY was restored, reducing the social medical expenses of 4 808 300 RMB, and restore social total value of 619 million RMB. The expense which is used to make a healthy person avoid infecting is 315.59 RMB. The expense which is used to restore 1 DALY is 240.27 RMB. Investing 1 RMB prevention funds can produce 28 RMBsocial and economic benefits. Conclusion:The realization of plan effectively promotes the communion and accessibility of TB’s prevention and treatment services in Autonomous Prefecture of Dali, hosing significant social effect and benefits and achieving the goal of regulating prerformance, the vision of planning come to fruition.%　　目的：对《大理白族自治州结核病防治规划（2002—2010）》实施绩效作卫生经济学评估，为制定下一阶段防治规划及卫生资源配置提供决策依据。方法：收集规划期内结核病防治工作资料作数据汇总，并与结核病信息管理系统数据相复核，进行成本与效果和效用及效益分析。结果：2002—2010年大理白族自治州共发现并治疗管理活动性肺结核17750例，其中涂阳肺结核9786例，完成规划目标的181.90%，治愈率为91.36%，优于规划指标6.36个百分点；避免新增感染70577例，避免新发病7058例，减少死亡4301例；挽回92701个伤残调整生命年（DALY），减少社会医疗费用480.83万元，挽回社会总价值6.19亿元；避免1个健康人受传染仅投入315.59元，挽回1个DALY损失仅投入240.27元，投入1元防治经费可产生28元社会经济效益。结论：规划实施有效地推进了全州结核病防治服务的共享性和可及性，取得了显著的社会效果和效用及效益，如期实现了规划绩效愿景。