结核病接触者的非传染性疾病综合查的成本和成本效益
IJTLD open
|March 17, 2025
概括
将非传染性疾病 (NCD) 查纳入结核病接触调查是不具有成本效益的,因为高的护理成本. 优先考虑高风险人群可以提高NCD查的成本效益.
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:
- 将非传染性疾病 (NCD) 查纳入结核病 (TB) 接触调查中提供了潜在的好处,但缺乏成本效益的证据.
- 关于将非传染性疾病查与结核病接触者追踪相结合的经济影响的数据有限.
研究的目的:
- 在结核病家庭接触调查中评估与综合性非传染性疾病查相关的患者和提供者的成本.
- 确定这种在识别和管理非传染性疾病方面的综合方法的成本效益.
主要方法:
- 在南非进行的横截面研究评估了对高血压,糖尿病,慢性病和脂质失调的查成本.
- 使用决策树建模来估计每年因残疾调整的增量成本 (DALY) 避免了10年.
- 使用世卫组织预测模型估计的心血管疾病 (CVD) 风险.
主要成果:
- 增量成本为每位被查的接触者72.3美元,每位被发现的NCD病例为334.0美元.
- 综合查将10年心血管疾病风险的平均水平从与非传染性疾病接触者的5.7%降低到2.7%.
- 增量成本效益比率 (ICER) 为每DALY27,043.6美元,超过了南非的门. 管理成本,主要是药品,占总增加成本的80%以上.
结论:
- 在结核病接触调查中综合进行非传染性疾病查并未被发现具有成本效益,主要是由于随后的非传染性疾病管理的高成本.
- 针对高风险非传染性疾病的个体进行查,显示了提高成本效益的潜力.
- 未来的战略应考虑风险分层,以优化综合选计划中的资源配置.
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