论文部分内容阅读
目的:脑卒中位列全世界60岁以上人口死因的第二位。依照澳大利亚在过去十年间脑卒中病例增长了1/3的增速来预测,目前每年大约有50 000例脑卒中新发病例。该研究的目的是通过以下两种途径来探索为了防治脑卒中而实施公共健康计划的经济学意义:(1)预测可以获得的潜在健康收益和成本补偿;(2)确定实现物有所值目标的每年投资实际水平。方法:如果现有的技术是可靠的,就可以测算新增加病例的终生成本和产出。估计某一特定年份的成本和产出的数据包括:(1)当地的流行病方面的数据、覆盖率和成本;(2)通过系统的调查汇总健康计划的效果。调查内容包括:血压降低、使用抗血凝剂减轻动脉纤维化、利用脑卒中治疗中心的增加、静脉溶栓和使用阿司匹林减少局部缺血,以及颈动脉内膜切除术。我们设定的物有所值的门槛是实现每挽救一个DALY为30 000澳元。结果:到2015年,通过促进、干预和管理能预防大约27 000(38%)例脑卒中病人。在现有的水平下(2004),大约85 000个伤残调整生命年和10.6亿澳元可以被重新获得,每年的实际投资水平为36.3亿澳元。结论:对脑卒中的预防的干预措施中,初级预防特别是降血压是最有效的。对脑卒中进行干预的公共健康计划是恰当的。
Purpose: Stroke ranks second in the cause of death among people over the age of 60 in the world. As Australia has seen a one-third increase in stroke cases over the past decade, there are currently about 50,000 new cases of stroke each year. The purpose of this study is to explore the economic implications of implementing a public health plan for stroke prevention in two ways: (1) to predict the potential health benefits and costs available for reimbursement; (2) to determine the value for money The actual annual investment level. Methodology: If the current technology is reliable, you can measure the lifetime cost and output of new cases. The data that estimates the costs and outputs for a given year include: (1) data on local epidemiology, coverage and costs; and (2) systematic reviews of health program effectiveness. Investigations included lowering blood pressure, reducing arterial fibrosis with anticoagulants, increasing use of stroke centers, intravenous thrombolysis and aspirin to reduce ischemia, and carotid endarterectomy. We set a value for money threshold of $ 30,000 per DALY saved. Results: By 2015, about 27,000 (38%) stroke patients will be prevented through promotion, intervention and management. At its current level (2004), about 85,000 disability-adjusted life years and 1.06 billion Australian dollars can be regained, with an actual annual investment of A $ 3.63 billion. Conclusion: Among the interventions for prevention of stroke, primary prevention, especially hypotensive hypotension, is the most effective. Public health programs that intervene in stroke are appropriate.