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目的 应用成本 效果分析对部队不同乙型肝炎 (乙肝 )疫苗接种方案进行比较 ,为制定经济有效的全军乙肝疫苗预防接种策略提供依据。方法 建立决策树和乙肝转归树 ,采用催化模型推算不同接种方案下易感人群年新感染率 ,用失能调整生命年 (disability adjustedlifeyear ,DALY)作为衡量效果的指标 ,计算增量成本效果比。结果 与不接种方案相比 ,直接接种方案和筛检再接种方案的DALY分别为 6 1.888和 5 7.175 ,增量成本效果比 (cost effectivenessratio ,CER)分别为 392 .70和2 5 1.90。用部队干部实际年龄构成进行加权 ,得到筛检再接种方案和直接接种方案的CER分别为2 5 1.9和 392 .7,即每获得一个健康生命年所需成本前者少于后者。结论 筛检再接种方案优于直接接种方案 ;年龄越小接种的效果越好
OBJECTIVE: To compare cost-effectiveness analysis of different Hepatitis B (HBV) vaccination programs in the army and provide evidence for establishing a cost-effective hepatitis B vaccine vaccination strategy. Methods The decision trees and the Hepatitis B-to-Hepatitis B-tree were established. The new infection rate of susceptible population under different vaccination programs was calculated using the catalytic model, and the disability adjusted lifeyear (DALY) was used as an index to measure the effect. The incremental cost- . Results Compared with the non-vaccinated regimen, the DALY of the direct vaccination regimen and the screening re-vaccination regimen were 6 1.888 and 5 7.175 respectively, and the cost effectiveness ratios (CERs) were 392.7 and 25.190 respectively. CERs weighted by the actual age composition of army cadres, screening re-vaccination programs and direct vaccination programs were 2 5 1.9 and 392.7, respectively, that is, the former is less than the latter for the cost of obtaining a healthy life year. Conclusion Screening re-vaccination program is better than direct vaccination program; the younger the effect of vaccination, the better