云南玉溪市1953-2015年疟疾防治效益成本分析

目的 了解玉溪市1953-2015年(62年)疟疾高度流行区疟疾防治的效益成本情况,为制定巩固消除疟疾成果可持续性防控策略和技术措施提供科学依据.方法 收集62年来疟疾防治过程中疟疾发病、死亡和住院人数;收集疟疾防治各种(类)投入和支出疟疾防治的人、财、物情况,计算总投入和总效益.国家、国际组织、集体和个人实际投入疟疾预防及治疗的人、财、物费用计为直接成本(直接投入),门诊和住院病人及培护的误工费计为间接成本(间接投入).用防治初期三年平均发病率、病死率和1978-1986年平均住院率计算总的发病数、死亡数和住院数,减去防治期间发病数、病死数和住院数.应用效益成本比率法(benefit-cost ratio,BCR)计算62年的疟疾防治效益成本情况.结果 全市在62年的疟疾防治中共收治233 327例,减少发病2 611 820例、减少死亡4 219例、减少住院52 645例、减少病人误工损失17 094 894 d,消除200余万居民感染疟疾的风险.国家投入,包括设备、药品、检测、培训、人力等九项支付经费5 905.51万元.个人投入医药费、住院费、误工费和陪护费等四项支出7 885.85万元.直接经济效益为减少支出139 309.26万元.间接经济效益为减少支出68 804.06万元.效益成本为18.41∶1,年平均净效益为3 174.36万.社会效益非常显著,无法估量.结论 当地62年的疟疾防治工作社会效益和经济效益非常显著,防治策略和技术措施可行有效,对保护社会和家庭劳动力起到了不可替代的重要作用.

Benefit-cost for malaria prevention and control in Yuxi,Yunnan, 1953-2015

Objective To understand the status of benefit-cost for malaria prevention and control in Yuxi City,Yunnan Province from 1953 to 2015,so as to provide the evidence for making the sustainable strategies of malaria prevention and control,and technical measures to consolidate the achievements of malaria elimination.Methods The data of malaria cases,deaths and inpatients,the fixed investment and efficient output at the aspect of people,money,substances,the totally input and efficient output were collected in Yuxi City from 1953 to 2015.The investments of the state,international organizations,groups and individuals for malaria prevention and control were as the direct costs (direct investment),and the costs of outpatient and inpatient care were as the indirect costs (indirect inputs).The average incidence and mortality in the initial control period (3 years) and the average hospitalization rate from 1978 to 1986 were calculated as the total number of cases,the number of deaths and the number of hospitalized patients,then the above results subtracted the number of patients,the number of deaths and the number of inpatients in the control period.The benefit-cost for malaria prevention and control in 62 years was calculated by the benefit-cost ratio.Results Totally 233 327 malaria cases were cured in Yuxi City within 62 years.The numbers of reducing cases,reducing deaths and reducing inpatients were 2 611 820,4 219 and 52 645 respectively.The reducing missedworking time was 17 094 894 days.Totally 2 million people avoided the risk of malaria.The input of the state,including equipment,drugs,testing,training,human resources and other nine funds was 59 055 100 yuan.The input of individuals in medical expenses,hospitalization expenses,lost income,accompanying expenses and other expenses was 78 858 500 yuan.The direct and indirect economic benefits were 1 393 092 600 yuan and 688 040 600 yuan respectively.The BCR was 18.41∶1,and the average annual net benefit was 31 743 600 yuan.Conclusion The social and economic benefits of malaria prevention and control work are very significant in Yuxi City from 1953 to 2015,and the prevention and control strategies and technical measures are very effective.