摘要
目的 :探讨西安市急性病毒性肝炎病原学筛选最优策略 .方法 :系统综述、成本效果分析 .结果 :1 2条分型策略中 ,成人组以HAV→HBV→HEV→HCV诊断费用最低 ,费用为1 4 989.0 2元 /千病例 ,成本效果比 (CER)为 1 7.72 .儿童组以HAV→HBV→HCV→HEV诊断费用最低 ,费用为 94 6 3.33元 /千病例 ,成本效果比 (CER)为 9.81 .总人口以策略HAV→HBV→HEV→HCV最经济 ,诊断费用为 1 35 70 .89元 /千病例 ,成本效果比 (CER) 1 5 .4 7.灵敏度分析显示甲肝发病增加以策略HAV→HBV→HCV→HEV为最佳诊断策略 ,如果甲肝发病为原来的 1 / 4以下及乙肝增加 3倍以上以策略HBV→HAV→HCV→HEV为最佳策略 .丙肝、戊肝发病率的变化对结果无影响 .结论 :西安市现行急性病毒性肝炎筛选方法 (甲、乙、丙、戊型肝炎同时检测 )的成本最高 ,HAV→HBV→HEV→HCV策略可以完成筛选任务 。
AIM: To seek the most economical diagnosis strategy for acute viral hepatitis. METHODS: Systemic review and cost effectiveness analysis were employed. RESULTS : The strategy of HAV→HBV→HEV→HCV with the total diagnosis cost of $14989.02 (RMB) per 1000 cases and the cost effectiveness ratio (CER) of 17.72 was the most economical one in adults group while in child group HAV→HBV→HCV→HEV was the most economical strategy with the total diagnosis cost of 9463.33 Yuan per 1000 cases and the CER 9.81. In general population HAV→HBV→HEV→HCV was the most economical strategy with the total diagnosis cost of $13570.89 (RMB) per 1000 cases and the CER 15.47. Sensitivity Analysis indicated that HAV→HBV→HCV→HEV was the most economical strategy if the incidence of hepatitis A increased. HBV→HAV→HCV→HEV was the most economical strategy if the incidence of hepatitis A decreased by a quarter of the original incidence or that of hepatitis B increased by 3 times. CONCLUSION: The screening strategy now in use in Xi'an for the detection of the possible hepatitis A B C and E virus is the most expensive strategy. The HAV→HBV→HEV→HCV strategy can do the screening effectively and economically.
出处
《第四军医大学学报》
北大核心
2003年第11期1027-1028,共2页
Journal of the Fourth Military Medical University
基金
全军"九五"指令课题 (39570 634)
关键词
急性肝炎
血清诊断
成本效果分析
acute viral hepatitis
serotyping diagnosis
cost effectiveness analysis
