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目的利用伤残调整健康生命年(disability adjusted lifeyear,DALY)指标分析江西省结核病防治经费投入和产出,计算成本效益比,为政府合理分配有限的卫生经费、制订结核病防治策略提供依据。方法根据《全国结核病防治规划(2011~2015年)中期评估方案》和实施细则,设区市和县级逐级上报、省级审核汇总。选用DALY指标量化,计算成本效益比。结果江西省2011~2015年共投入结核病防治经费31 581.16万元,减少的医疗费用为5 351.22万元,挽回的社会总价值为2 361 493.13万元,产生的总效益为2 366 844.35万元,挽回的总DALY值为1 099 273.5,每挽回1个DALY平均需要投入金额为287.29元,成本效益比为74.94,即每投入1元可产生74.94元的社会经济效益。结论 5年间江西省结核病防治成本效益显著。但全省仍需加强各级财政投入特别是市和县两级财政投入,通过多种形式宣传提高公众结核病防治知识知晓率,继续执行现有的结核病防控策略。
Objective To analyze the input and output of tuberculosis prevention and treatment in Jiangxi Province using the disability adjusted lifeyear (DALY) index and calculate the cost-benefit ratio, and provide the basis for the government to rationally allocate limited health funds and formulate tuberculosis prevention and control strategies. Methods According to the “National Tuberculosis Prevention and Control Plan (2011-2015) Mid-term Evaluation Plan” and the implementation details, district and county-level reporting and provincial-level review and summary were made. Use DALY indicators quantify the cost-benefit ratio. Results In 2011-2015, Jiangxi Province invested a total of 315.8161 million yuan in prevention and treatment of tuberculosis, with a reduction in medical expenses of 51.5122 million yuan. The total social value of the society recovered was 23.61993.13 million yuan, with a total benefit of 23.686.44435 billion yuan, The total value of DALY retrieved is 1 099 273.5. The average amount of investment required to restore one DALY is 287.29 yuan and the cost-benefit ratio is 74.94. That is, each input of 1 yuan can produce a social and economic benefit of 74.94 yuan. Conclusion The cost-effectiveness of tuberculosis prevention and treatment in Jiangxi Province in 5 years is significant. However, the province still needs to step up financial input at all levels, especially at the city and county levels, and promote the public awareness of tuberculosis prevention and control through various forms of publicity to continue implementing the existing tuberculosis prevention and control strategies.