在资源较少的环境中优化心血管疾病风险查:斯里兰卡计划修改的成本效益以国家代表性调查数据为模型
Nilmini Wijemunige1,2, Ravindra P Rannan-Eliya3, Pieter van Baal4
1Institute for Health Policy, 72 Park Street, Colombo 2, Colombo, Western Province, Sri Lanka. nilmini@ihp.lk.
BMC public health
|September 15, 2023
概括
在斯里兰卡优化心血管疾病 (CVD) 查,使用WHO-2019工具和查40岁以上的个人,证明非常具有成本效益. 调整风险和血压值进一步提高了公共卫生系统的价值.
科学领域:
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
- 流行病学 流行病学
背景情况:
- 预防心血管疾病 (CVD) 对资源有限的卫生系统至关重要.
- 为了最大限度地影响,必须将国际查指南适应当地环境.
- 斯里兰卡心血管疾病风险查的成本效益需要当地证据.
研究的目的:
- 为了确定斯里兰卡CVD风险查的成本效益.
- 分析基于查人口统计,风险评估工具和治疗门的变化.
- 在国家范围内为预防心血管疾病提供最佳策略的信息.
主要方法:
- 利用了来自斯里兰卡 (2018/19) 的全国代表性调查数据,针对35岁及以上的个人.
- 从公共卫生系统的角度来看,采用马尔科夫模型模拟一年的查计划,具有终身视野.
- 评估了128个不同的查计划场景,不同的年龄组,风险工具,风险值,血压治疗目标和糖尿病人的他类药物处方.
主要成果:
- 结合WHO-2019基于办公室的风险工具的情景显示出卓越的成本效益.
- 使用WHO-2019工具对40岁及以上的个人进行查,产生了113美元/QALY的ICER.
- 降低心血管疾病风险值和治疗血压目标,导致ICER为1,159美元/QALY,对药物无用性敏感.
结论:
- 斯里兰卡的心血管疾病风险查在利用世卫组织2019年工具和查40岁以上的个人时具有成本效益.
- 调整治疗的风险和血压值可以进一步提高成本效益.
- 这些优化战略以低于人均GDP的一半的成本产生额外的QALY.
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