128个国家的艾滋病毒/艾滋病,疟疾,梅毒和结核病干预措施的成本效益:一个元回归分析
Fiona Silke1, Lauren Earl1, Johnathan Hsu1
1Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA.
The Lancet. Global health
|June 14, 2024
概括
对艾滋病毒/艾滋病,疟疾,梅毒和结核病干预措施的成本效益分析因国家而异. 超回归预测了增量成本效益比率 (ICERs),以指导14项推干预措施的资源分配.
科学领域:
- 全球卫生经济学 全球卫生经济学
- 公共卫生干预分析分析
- 在卫生政策中的计量经济学.
背景情况:
- 成本效益分析 (CEA) 对全球卫生资源分配至关重要,但并非所有推的干预措施都已被评估.
- 现有的艾滋病毒/艾滋病,疟疾,梅毒和结核病干预措施的CEA缺乏综合的国家特定数据.
- 国家决策者需要可靠的数据来有效地分配疾病控制计划的资源.
研究的目的:
- 对针对艾滋病毒/艾滋病,疟疾,梅毒和结核病的干预措施发布的增量成本效益比率 (ICER) 进行元回归分析.
- 预测全球基金资格国家目前推的14项干预措施的特定国家ICER.
- 为优化公共卫生决策中的资源分配提供基于证据的指导.
主要方法:
- 使用塔夫斯成本效益注册表 (截至2018年1月1日) 的数据进行了元回归分析.
- 数据进行了标准化和映射,结合了全球疾病负担,伤害和风险因素研究 (GBD) 的变量.
- 一个五阶段的统计模型综合了证据,预测了14项干预措施的中位数ICER,IQR和每残疾调整寿命年 (DALY) 的不确定性间隔.
主要成果:
- 该分析包括来自106篇文章的612个ICER,涵盖艾滋病毒/艾滋病,疟疾,梅毒和结核病的干预措施.
- 预测的ICER因国家而异;例如,在苏丹的14项干预中,有6项低于国家特定门,而在秘鲁则为12项.
- 在63%的国家中,产前梅毒查显示了最低的ICER中位数,而与男性发生性关系的男性的HIV暴露前预防在91%的国家中显示了最高的ICER中位数.
结论:
- 从元回归生成的国家特定排行榜,为干预的成本效益提供了宝贵的见解.
- 这些量身定制的分析支持决策,更好地与国家特定的资源和卫生优先事项保持一致.
- 超回归是一种强大的方法,可以在不同的环境中合成和转移成本效益证据.
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