"食管癌早诊早治方案"的经济学评价

背景与目的：在中国,食管癌是死亡率位于前四位的恶性肿瘤之一,其5年生存率不足10％。食管癌的早期发现与治疗对提高患者生存率至关重要。本研究以近期在食管癌高发区河南省林州市开展的“食管癌早诊早治”的研究为背景,从成本效益角度对该食管癌筛查和早诊早治方案进行初步评价,以研究该方案带来的经济效益与社会效益。方法：采用分层抽样法对食管癌高发区河南省林州市3家医院136名食管癌住院或门诊患者进行问卷调查,同时对53名食管癌患者进行入户调查,以估算自然发生的食管癌“传统疗法”花费。以参加在该地开展的内镜筛查和早诊早治研究中的936人为背景,估算“食管癌早诊早治方案”的花费,对该方案进行成本效益分析和食管癌患者疾病经济负担研究。结果：食管癌“传统疗法”花费为人均7183元。参加内镜筛查的936人中,“食管癌早诊早治方案”的成本是148246元,效益是589006元,效益成本差为440760元,效益成本比率为4：1,患者治疗疾病的花费与家庭年总收入的比由1．300降为0．125。结论：“食管癌早诊早治方案”的成本低,效益好,且能降低食管癌患者的疾病经济负担。

Economic evaluation of "early detection and treatment of esophageal cancer"

BACKGROUND & OBJECTIVE: In China, esophageal cancer is the forth death cause of malignant cancers. The survival rate of esophageal cancer patients is less than 10%. Early detection and treatment of esophageal cancer is essential to improve the survival rate of these patients. This study was to evaluate the economic and social benefits of the project "early detection and treatment of esophageal cancer" through cost-benefit analysis, so as to provide evidence to extend this project. METHODS: Interview with structured questionnaires was conducted by stratified sampling among 136 esophageal cancer patients in 3 hospitals at Linzhou City, and a sampling survey was conducted among 53 patients at their homes afterwards. The 2 surveys measured the expense of "traditional treatment of esophageal cancer". Based on an intervention study of "early detection and treatment of esophageal cancer" among 936 persons at Linzhou City, cost-benefit analysis and the evaluation of economic burden of disease among esophageal cancer patients were carried out. RESULTS: The expense of "traditional treatment of esophageal cancer" was 7,183 Yuan per patient. Regarding the 936 persons who were recruited to the intervention study, the cost was 148,246 Yuan, and the benefit was 589,006 Yuan. The difference between benefit and cost of the project was 440,760 Yuan. The benefit-cost ratio was 4:1. By the project, the ratio of the expense in treating disease to the total family income in 1 year was reduced from 1.300 to 0.125. CONCLUSION: The cost of "early detection and treatment of esophageal cancer" is low, while the benefit is high, and the project can also lighten the economic burden of esophageal cancer patients.