使用临床乳腺检查进行乳腺癌查:南非的成本效益分析
Sithabiso D Masuku1, Olena Mandrik2, Noreen D Mdege3
1Health Economics and Epidemiology Research Office, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; SCHARR, Sheffield Centre for Health and Related Research, Division of Population Health, School of Medicine and Population Health, University of Sheffield, Sheffield, England, UK.
Value in health regional issues
|May 28, 2025
概括
在南非扩大临床乳腺检查 (CBE) 的规模,通过减少乳腺癌死亡率来挽救生命. 然而,与该国门相比,增加查的成本效益并不高.
科学领域:
- 公共卫生 公共卫生
- 在瘤学瘤学.
- 卫生经济学 卫生经济学
背景情况:
- 低至中等收入国家面临着乳腺癌晚期检测的挑战,导致生存率低下.
- 南非建议每年两次对40-69岁的女性进行临床乳房检查 (CBE).
- 评估扩大CBE查对死亡率和成本效益的影响对于公共卫生政策至关重要.
研究的目的:
- 评估增加临床乳腺检查 (CBE) 查覆盖范围对乳腺癌死亡率的影响.
- 评估南非扩大CBE查计划的成本效益.
- 在资源有限的环境中,为有关乳腺癌查策略的政策决策提供信息.
主要方法:
- 用一个队列模型来模拟由于查而导致乳腺癌衰退的终身影响.
- 两种情景被比较:25%的覆盖率 (情景1) 和75%的覆盖率 (情景2) 到第五年,相对于5%的覆盖率的基线.
- 从2022年美元的医疗保健支付人的角度分析了成本,计算每年残疾调整寿命 (DALY) 的成本.
主要成果:
- 增加CBE查覆盖率降低了乳腺癌死亡率,第二种情景 (75%覆盖率) 显示2.3%的减少.
- 第一个场景避免了3823个DALY,每次17776美元/DALY,第二个场景避免了12165个DALY,每次19552美元/DALY.
- 尽管避免了生命年数,但这两种扩大规模的方案都超过了南非的成本效益值,即避免了3015/DALY.
结论:
- 在南非,扩大临床乳房检查 (CBE) 的规模可以节省生命,但在既定门下,成本效益不高.
- 政策决策需要平衡成本效益与预算限制和医疗保健优先事项.
- 未来的扩展战略应考虑系统容量,最低护理标准和具有成本效益的早期检测方法.
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