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中国慢性阻塞性肺病人口查的成本效益:一个模拟建模研究

Qiushi Chen¹, Yiwen Fan², Ke Huang³

¹The Harold and Inge Marcus Department of Industrial and Manufacturing Engineering, The Pennsylvania State University, University Park, PA, USA.

The Lancet regional health. Western Pacific

|May 9, 2024

概括

在中国,以人口为基础的慢性阻塞性肺病 (COPD) 查具有成本效益. 年度两步查提供了最好的价值,可能避免死亡和恶化.

科学领域:

公共卫生公共卫生
卫生经济学卫生经济学
呼吸系统医学呼吸系统医学

背景情况:

中国面临着世界上最严重的慢性阻塞性肺病 (COPD),但诊断率仍然很低.
基于人口的查可以提高早期诊断,并改善长期患者的结果.
本研究评估了在中国实施基于人口的COPD查政策的成本效益.

研究的目的:

评估中国各种基于人口的COPD查策略的经济可行性.
确定在中国人口中最具成本效益的COPD查政策.
确定查对COPD相关死亡率和恶化的潜在影响.

主要方法:

研发了一种微模拟模型,模拟中国35-80岁人口一生中COPD的发病率,自然史和管理情况.
评估了一步 (问卷) 和两步 (问卷 + 螺旋计) 的查方法,频率不同 (每10年一次).
与没有查相比计算的增量成本效益比率 (ICER),进行了敏感性和场景分析.

主要成果:

所有评估的COPD查政策都具有成本效益,ICERs从每QALY8034美元到13,209美元,低于支付意愿的门.
查可以避免0.39%-8.10%的COPD死亡和0.58%-2.70%的恶化.
年度两步查成为最具成本效益的策略;改善诊断和治疗联系进一步增强了效益.

结论:

基于人口的COPD查对中国来说是一个具有成本效益的战略.
实施公共COPD查计划,类似于其他慢性疾病的查计划,可以改善健康结果并减少国家COPD负担.
优化从查到诊断和治疗的途径对于最大限度地提高人口健康效益至关重要.

关键词:

慢性阻塞性肺病是一种慢性阻塞性肺病.对成本效益的分析.微观模拟是一种微观模拟.基于人口的查.公共卫生政策公共卫生政策

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