2002～2005年上海市社区肝癌高危人群筛检成本效果分析

[目的]评估2002~2005年上海市社区肝癌高危人群筛检的效果,从卫生经济学方面探讨经济有效的筛检方法。[方法]对上海市健康档案和医院门诊对象中符合肝癌高危人群标准并愿意参加的3 280例对象进行“AFP+B超”筛检。运用项目成本测算方法计算筛检的成本,以发生肝癌例数和早中期肝癌例数作为效果指标进行成本效果分析。[结果]社区肝癌高危人群筛检的总成本为4 025 544.00元。高危人群的随访筛检次均成本为411.80元。去除间接成本部分,次均直接成本为21.80元,次均自付直接成本为15.00元。发现1例肝癌和早中期(Ⅰ期和Ⅱ期)肝癌患者的总成本分别为575 077.71元和1 006 386.00元。[结论]以10万人社区为假设,每人每年增加0.24元专项肿瘤筛查经费就能有效地发现早中期肝癌患者。

Cost - effectiveness analysis of liver cancer screening among residents with high risk in Shanghai in 2002 - 2005

[ Objective] To study the cost - effectiveness analysis of liver cancer screening among residents with high risk factors in Shanghai in 2002 - 2005. [ Methods ] 3 280 people with high risk factors for liver cancer were selected through the information provided by Shanghai Health Archives and hospital data. They were given health education and invited to take part in the liver cancer screening. Screening effectiveness was estimated by means of cost effectiveness analysis. [ Results] The total cost of liver cancer screening in Shanghai was 4.0 million Yuan. The cost per screening was 411.8 Yuan, and the direct cost per screening was 21.8 Yuan excluding indirect cost. Out of pocket cost was 15.0 Yuan. The total cost per liver cancer and early stage cancer patient was 57.5 and 1.0 million Yuan respectively. [ Conclusion ] If a community has 100 thousand residents, if 0.24 Yuan per person annually is given to push the liver cancer screening program, the early stage liver cancer patients may be effectively detected.