贵州省农村癫痫项目点防治管理的成本-效用分析

目的 了解贵州省内农村癫痫项目覆盖地区参与管理治疗和自行治疗的癫痫患者在治疗后，费用和生存质量改善方面的情况，为管理治疗癫痫的后期成本投入提供科学依据。方法 采用QOLIE-31量表收集2组癫痫患者的生存质量情况，并计算改善的QALY值，依据卫生经济学的分析方法，计算其成本效用。结果 经比较，项目组与非项目组的各项指标均无统计学差异，具有较好的比较性。项目组平均QALY为30.14，非项目组为17.62，QALY的改善主要集中在中青年癫痫患者；项目组平均改善1个QALY需要20 903.8元，非项目组为24 201.4元，项目组人均成本效用比为34.10，而非项目组为136.73。结论 农村癫痫防治管理项目在提高农村癫痫患者的生存质量方面具有经济优势，作为一项惠民政策，应该逐步推广综合干预模式，为其他农村综合防治项目提供参考。

Cost-utility analysis of the management of the prevention and control of epilepsy in rural areas of Guizhou Province

Objective The study aimed to assess the improvements in life quality and treatment costs among participating and non-participating epilepsy patients in the rural epilepsy project coverage areas in Guizhou Province, and thus to provide a scientific reference for the investment cost for late-stage management and treatment of epilepsy. Methods The quality of life of two groups of epilepsy patients was assessed by QOLIE-31, and the improved QALY values were determined. The cost-utility was calculated according to health economics methods. Results The analyses showed that all indicators of the participating group and the non-participating group were not statistically different and were comparable. The average QALY of the participating group and the non-participating group were 30.14 and 17.62, respectively. Improvement in QALY was mainly observed among young and middle-aged epileptic patients. On average, improvement of 1 QALY required 20903.8 RMB and 24201.4 RMB for the participating group and the non-participating group, respectively. The cost-utility ratios per capita were 34.10 and 136.73 for the participating group and the non-participating group, respectively. Conclusion The prevention and control management of epilepsy in rural areas is economically advantageous in improving the quality of life of rural epileptic patients. As a farmer-friendly policy, the comprehensive intervention should be progressively implemented, so as to provide a reference for other rural comprehensive prevention and control projects.