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在印度发现白内障和未经纠正的折射误差病例的策略:规模上的成本和成本效益
Brad Wong1, Kuldeep Singh2, Rohit C Khanna3
1Mettalytics, New South Wales, Australia.
The Lancet regional health. Southeast Asia
|June 29, 2023
概括
眼部营地和视觉中心是最具成本效益的策略,用于识别和鼓励印度的纠正眼部服务. 视觉中心在规模上表现出更高的成本效益,突出了投资眼睛健康的价值.
科学领域:
- 公共卫生 公共卫生
- 眼科医生 眼科 眼科
- 卫生经济学 卫生经济学
背景情况:
- 印度面临着全球视力障碍和失明的高负担.
- 由于需求方面的因素,超过80%的个人不寻求眼科服务.
- 具有成本效益的案例寻找策略对于解决这一差距至关重要.
研究的目的:
- 评估各种策略的总成本和成本效益,以确定和促进纠正眼睛服务.
- 为了比较印度不同案例发现干预措施的经济效率.
主要方法:
- 五个案例发现干预措施 (视觉中心,学校查,眼部营地,门户活动) 的回顾性微成本分析.
- 数据来自6家印度眼科医院,覆盖超过140万人.
- 估计病例发现,治疗启动 (未纠正的折射误差和白内障) 的提供者成本,以及每次避免的DALY的社会成本.
- 蒙特卡洛模拟用于确定置信区间.
主要成果:
- 眼部营地和视觉中心在未纠正的折射误差 (URE) 和白内障方面表现出最低的病例发现和治疗启动成本.
- 门对门查对白内障来说是具有成本效益的,但对于URE来说更昂贵.
- 学校查为URE病例发现带来了最高的成本.
- 视觉中心实现了最高的患者覆盖率,并在规模上显示越来越高的成本效益.
- 增量成本效益比率 (ICERs) 为眼部营地每日143美元,视觉中心每日262美元.
结论:
- 查营和视觉中心是印度发现病例和启动治疗的最经济可行的策略.
- 预计视觉中心在较大规模上最具成本效益.
- 印度对眼睛健康的持续投资仍然非常具有成本效益.
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