新疆生产建设兵团1997～1999年居民期望寿命调查分析

目的：分析新疆生产建设兵团20世纪末的居民期望寿命和与寿命有关的指标。方法：采用分层胡机抽样方法，获得期望寿命，死亡率，死因顺位，去死因寿命，潜在减寿年数（YPLL）及人口长寿水平等指标，并对各项指标进行简要分析。结果：新疆生产兵团（兵团）1997－1999年期望寿命为75．61岁，男为72．73岁，女性为80．02岁；农牧团场的期望寿命为73．97岁，相对较低；经济水平高的地区期望寿命较高较高；北疆地区期望寿命高于南疆和东疆，年平均粗死亡率为5．17‰（标化死亡率为4．53‰）。主要死因顺位为：恶性肿瘤、脑血管病，呼吸系统疾病，心脏病，损伤与中毒，传染病与寄生虫病以及围产期情况。7种死因中，去除呼吸系统疾病和围产期情况寿命增幅较明显。主要死因的潜在减行率和标准化潜在减寿（SYPLL）率顺位的第1位均为意外死亡。经济水平较高地区长寿水平也较高，结论：兵团人均期望寿命水平较高，但不同地区相差较大，为全面提高居民健康水平，既要加强自然环境的治理和扶贫力度。也要重视呼吸系统（尤其是婴儿）、老年慢性病的防治和提高围期产期保健质量，进一步改善社会保障环境，降低损伤中毒的发生率。     

长寿之乡如皋市如城镇居民死因及YPLL分析

目的了解长寿之乡如皋市如城镇居民死因和寿命损失特征,为制定卫生保健策略提供依据。方法分析居民各类死因的死亡率、构成、顺位及潜在减寿人年数等指标。结果全镇总死亡率为735.94/10万(标化411.57/10万),死因顺位前五位为恶性肿瘤、脑血管病、呼吸系统、心脏病、损伤和中毒;慢性非传染性疾病占总死亡的89.27%,比例很高;潜在寿命损失年最高为恶性肿瘤;恶性肿瘤中死亡率首位为肝癌,消化系肿瘤几乎都出现在前十位中,潜在寿命损失年首位亦为肝癌。结论人口老龄化后,恶性肿瘤死亡较心脑血管、呼吸系统疾病位次更为前移,慢性非传染性疾病成卫生保健重点。     

Economic evaluation of long-term albumin use in cirrhosis patients from the Mexican healthcare system perspective

Introduction and objectivesLiver cirrhosis is a major public health issue associated with high morbidity and mortality. The ANSWER trial showed that long-term human albumin (LTA) infusions led to significant reduction of complications and mortality in patients with uncomplicated ascites. The present study aimed to assess the incremental cost of cirrhosis patients treated with LTA plus standard medical treatment (SMT) versus those treated with SMT from the perspective of the Mexican Social Security Institute (IMSS).Material and methodsCost of illness for patients with cirrhosis and grade 2-3 ascites treated with SMT or with SMT and LTA (following the treatment regimen from ANSWER) over a one-year period was estimated according to the IMSS perspective. Rates of treatments, complications and hospitalizations were based on results from the ANSWER trial. Unit costs from IMSS were gathered from public sources and transformed to 2020 Mexican $ (Mex$).ResultsThe use of LTA is estimated to require additional annual expenditure derived from the pharmacological cost of human albumin and by the follow up visits required for LTA administration (Mex$28,128). However, this cost may potentially be counterbalanced by the reduction in paracentesis, cirrhosis-related complications and hospitalizations which would lead to cost savings of Mex$33,417 per patient/year.ConclusionsBased on the ANSWER trial results, our study suggests that LTA may result in improved clinical outcomes and reduced costs for the IMSS when administered to cirrhosis patients with uncomplicated ascites.     

晚期血吸虫病疾病负担评价方法的比较研究

目的　比较晚期血吸虫病（晚血）伤残调整寿命年（Disability?adjusted life year, DALY）的评价方法，为准确评价晚血疾病负担提供依据。方法　以2017年湖南省晚血救助病例为研究对象，分别采用全球疾病负担（The global burden of disease and injury，GBD）通用症状法、增加晚血常见症状后的改良GBD法和基于患者生命质量评价的生命质量法，计算晚血患者健康寿命损失年（Years lived with disability, YLDs）。结果　GBD通用症状法计算得出湖南省晚血患者YLDs为673.94 人·年，人均YLDs为0.181人·年，YLDs率为10.61人·年/10万人；改良GBD法计算得出晚血患者YLDs为728.77人·年，人均YLDs为0.196人·年，YLDs率为11.48人·年/10万人；生命质量法计算得出晚血患者YLDs为1 761.99人·年，人均YLDs为0.474人·年，YLDs率为27.75人·年/10万人。改良GBD法计算所得湖南省晚血患者YLDs较GBD通用症状法高8.14%，生命质量法计算所得YLDs是GBD通用症状法的2.61倍。在纳入计算的各种主要晚血症状中，按照对晚血疾病负担贡献的高低排序，依次为腹水、中度贫血、重度贫血、腹泻和便血。结论　与GBD通用症状法、改良GBD法相比，生命质量法能更全面地评估晚血患者的YLDs。     

血吸虫病疾病负担的研究I慢性血吸虫病健康寿命损失年的计算与评价

目的探讨慢性血吸虫病疾病负担的评价指标及其计算方法。方法根据2004-2005年在湖区两县开展的血吸虫病流行病学专题调查数据分别计算居民不同年龄组、性别和流行村类型等的专属血吸虫病患病率。根据专题调查得出的年龄别伤残权重,按年龄和性别分层,求得健康寿命损失年（YLD）及YLD率,并推算两县的总体YLD。结果当涂县总体YLD为1056.26人年,汉寿县总体YLD为3967.43人年。两县一类村YLD占慢性血吸虫病疾病负担的37.95%,高年龄组和男性的YLD率较高。与非流行区比较,慢性血吸虫病给流行区人口平均增加了4.398人年/1000人（当涂县）和1.505人年/1000人（汉寿县）的疾病负担。结论对慢性血吸虫病YLD进行评价,有助于确定重点干预地区和人群,并可为干预措施的效果评价等提供新指标。     

无锡市气温对非意外死亡及寿命损失年影响的时间序列分析

目的 了解无锡市气温在不同滞后日对非意外死亡(A00-R99)人数及寿命损失年的影响。 方法 收集无锡市区(2012-2017年)非意外死亡与气象数据资料,利用分布滞后非线性模型研究气温与非意外死亡人数及寿命损失年的关系,分析低温、高温在不同滞后日期对非意外死亡的累积效应。 结果 无锡市日均气温对非意外死亡效应曲线为"V"形,冷效应具有延迟性,在滞后3 d开始出现并持续14 d,热效应表现为急性效应,当天就出现。低温对人群总效应大于高温;不同年龄、性别对冷、热效应敏感性存在差异。 结论 低温和高温均可增加非意外死亡风险,冷效应起效慢且持续时间长,热效应急促,低温对人群影响更大。     

血吸虫病疾病负担研究II慢性血吸虫病健康不公平性的测量

目的对慢性血吸虫病所致的健康不公平性进行测量与评价。方法以湖区两县慢性血吸虫病的健康寿命损失年为基础数据,采用集中指数（曲线）和基尼系数（洛伦兹曲线）对慢性血吸虫病疾病负担在年龄和地区间的分布差异进行定量分析。结果女性和男性年龄集中指数分别为0.395和0.380,男女间无明显差异;仅占人口总数30%的45岁以上各人群疾病负担均约占各自总体的近60%。当涂县和汉寿县基尼指数分别为0.666和0.451,一类村和二类村的疾病负担占各县总量的60%以上。结论集中指数和基尼系数及相关曲线直观量化了慢性血吸虫病所致的健康不公平性,45岁以上人群和二类以上流行村是病情控制的重点。     

Mortality and years of life lost of colorectal cancer in China, 2005–2020: findings from the national mortality surveillance system

Background:Colorectal cancer (CRC) is the fourth cause of cancer death in China. We aimed to provide national and subnational estimates and changes of CRC premature mortality burden during 2005–2020.Methods:Data from multi-source on the basis of the national surveillance mortality system were used to estimate mortality and years of life lost (YLL) of CRC in the Chinese population during 2005–2020. Estimates were generated and compared for 31 provincial-level administrative divisions in China.Results:Estimated CRC deaths increased from 111.41 thousand in 2005 to 178.02 thousand in 2020; age-standardized mortality rate decreased from 10.01 per 100,000 in 2005 to 9.68 per 100,000 in 2020. Substantial reduction in CRC premature mortality burden, as measured by age-standardized YLL rate, was observed with a reduction of 10.20% nationwide. Marked differences were observed in the geographical patterns of provincial units, and they appeared to be obvious in areas with higher economic development. Population aging was the dominant driver which contributed to the increase in CRC deaths, followed by population growth and age-specific mortality change.Conclusions:Substantial discrepancies were observed in the premature mortality burden of CRC across China. Targeted considerations were needed to promote a healthy lifestyle, expand cost-effective CRC early screening and diagnosis, and improve medical treatment to reduce CRC mortality among high-risk populations and regions with inadequate healthcare resources.     

Influenza economic burden among potential target risk groups for immunization in South Africa, 2013–2015

BackgroundData on influenza economic burden in risk groups for severe influenza are important to guide targeted influenza immunization, especially in resource-limited settings. However, this information is limited in low- and middle-income countries.MethodsWe estimated the cost (from a health system and societal perspective) and years of life lost (YLL) for influenza-associated illness in South Africa during 2013–2015 among (i) children aged 6–59 months, (ii) individuals aged 5–64 years with HIV, pulmonary tuberculosis (PTB) and selected underlying medical conditions (UMC), separately, (iii) pregnant women and (iv) individuals aged ≥65 years, using publicly available data and data collected through laboratory-confirmed influenza surveillance and costing studies. All costs were expressed in 2015 prices using the South Africa all-items Consumer Price Index.ResultsDuring 2013–2015, the mean annual cost of influenza-associated illness among the selected risk groups accounted for 52.1% ($140.9/$270.5 million) of the total influenza-associated illness cost (for the entire population of South Africa), 45.2% ($52.2/$115.5 million) of non-medically attended illness costs, 43.3% ($46.7/$107.9 million) of medically-attended mild illness costs and 89.3% ($42.0/$47.1 million) of medically-attended severe illness costs. The YLL among the selected risk groups accounted for 86.0% (262,069 /304,867 years) of the total YLL due to influenza-associated death.ConclusionIn South Africa, individuals in risk groups for severe influenza accounted for approximately half of the total influenza-associated illness cost but most of the cost of influenza-associated medically attended severe illness and YLL. This study provides the foundation for future studies on the cost-effectiveness of influenza immunization among risk groups.