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背景:对于公立和私立机构合作(PPM)诊断和治疗结核病的成本效益方面的了解尚不足。设计:从新的国家结核病防治规划(RNTCP)角度,评价印度坎纳地区私立机构实验室开展PPM项目的花费及成本-效益。我们估算了每聘用并维持一个服务提供者的花费,估算了在不同效率假设的情况下多发现1例病人的花费、以及多成功治疗1例病人的花费。有关这些干预措施的花费的数据来自于国家结核病控制规划的登记资料,治疗花费的估算基于国家结核病控制规划的病例管理方案。结果:本项目每年总的估算花费为8 712～11611美元,平均每聘用1个私立服务提供者的费用从22～54美元不等,私立机构多诊断1例肺结核病人的花费为14～18美元。多登记1个病人,最保守的估算需花费29～36美元。每成功治疗1例抗酸杆菌阳性的病人约花费47～51美元。提高报告率会改善成本效益。结论:与公立卫生机构的诊断费用相比,需要明确这项干预措施是否对不同实施级别的公共卫生系统在经济上具有吸引力;如需扩展PPM项目,需要明确补充资源的需求。
Background: There is not enough understanding of the cost-effectiveness of public-private partnership (PPM) diagnosis and treatment of tuberculosis. Design: Evaluate the cost and effectiveness of PPM projects undertaken by private sector laboratories in Kanna, India, from the perspective of the new National Tuberculosis Prevention and Control Program (RNTCP). We estimated the cost of hiring and maintaining a service provider, estimating the cost of finding one additional patient under different efficiency assumptions, and the cost of successfully treating one patient. Data on the costs of these interventions come from the registration data of the national tuberculosis control program and the estimates of treatment costs are based on the case management programs of the national tuberculosis control program. Results: The total annual cost of this project was estimated to be $ 8 712- $ 11611, with an average fee of $ 22- $ 54 for each private employment service provider. The cost of multi-diagnosis of one case of tuberculosis in the private sector was $ 14- $ 18 . One more patient is enrolled, and the most conservative estimate will cost 29-36 dollars. One successful treatment of acid-fast bacilli per patient successfully costs approximately $ 47- $ 51. Increasing the reporting rate will improve cost-effectiveness. Conclusions: There is a need to clarify whether this intervention is economically attractive to public health systems at different levels of implementation as compared to the costs of public health agencies. Expansion of PPM projects requires clear resource replenishment needs.