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目的从卫生经济学角度对注射吸毒人员(IDU)清洁针具发放综合干预服务进行成本效益分析,为总结推广提供参考。方法利用云南省艾滋病亚洲区域项目(HAARP)19个县网络数据库回顾性收集项目参与人员能力建设、宣传及干预转诊经费投入、服务IDU人数及人次数、发放清洁针具及安全套数量、转诊数量、干预条件下目标人群高危行为特征、艾滋病病毒(HIV)感染率变化,进行年度成本效益比对分析。结果 2008—2011年云南省19个县204名外展人员共为12 413名IDU提供394 321人次服务,发放清洁针具3 586 160只、安全套585384只,转诊12 406人次,共投入成本9 058 398元,共挽回伤残调整寿命年(DALY)5 144.7人年,因避免HIV感染挽回经济效益59 515 776元,产生净效益50 460 37元,成本效益比为1∶5.6。结论云南省清洁针具发放综合干预服务卫生经济成本效益明显,对控制艾滋病的传播具有重要意义。
Objective To analyze the cost-benefit analysis of integrated intervention service for IDU cleaning needle from the perspective of health economics, and provide a reference for summarizing the promotion. Methods The database of 19 counties of HAARP in Yunnan Province was used to retrospectively collect the capacity of project participants, publicize and intervene the funding of referrals, the number of IDU and the number of people served, the number of clean needles and condoms, referral The number of high-risk behavior of the target population under the conditions of intervention, HIV infection rate changes, the annual cost-benefit comparison analysis. Results From 2008 to 2011, 204 outreach workers from 19 counties in Yunnan Province provided 394 321 service to 12 413 IDUs, distributed 3 586 160 clean needles, 585 384 condoms and 12 406 referrals for a total cost of 9 058 398 yuan, a total of 5 144.7 person-years of disability-adjusted life span (DALY) were retrieved, economic benefit of 59,515,776 yuan was saved by avoiding HIV infection, and the net benefit was 50,460,377 yuan, the cost-benefit ratio was 1: 5.6. Conclusion Yunnan Province, a comprehensive intervention services to clean the health costs of the economy obvious benefits to control the spread of AIDS is of great significance.