目的 对2013年广西壮族自治区3个国家科技重大专项示范县开展的HIV筛查项目进行成本效果分析.方法 计算广西HIV筛查项目实施期间执行的经费,统计项目检出的HIV/AIDS和抗病毒治疗数据,建立马尔科夫(Markov)5树模型,评估该项目获得的质量调整生命年(QALY),分析该项目的成本效果.结果 2013年度广西3个示范县区共投入经费1 920.5万元用于HIV筛查项目,检出HIV/AIDS阳性1 218例,3个示范县HIV/AIDS阳性检出的平均成本为1.456万元/例、1.842万元/例和1.404万元/例,通过检出HIV/AIDS获得的QALY平均数分别为12.736、8.523和8.321个,挽回的QALY总数分别为5 973.184个、3 613.752个和2 704.325个;项目整体成本效果为0.156万元/QALY,各示范县分别为0.114万元/QALY、0.216万元/QALY和0.169万元/QALY,A县成本效果指标优于B、C县.结论 广西示范县HIV筛查项目成本效益较好,但HIV/AIDS阳性检出的平均成本较高,加强HIV/AIDS的抗病毒治疗工作有利于提高该项目的成本效益。
Objective To analyze the cost effectiveness of HIV screening project in three Guangxi infectious disease special demonstration project countries in 2013.Methods To calculate the funds used for the HIV screening project and to study the data on HIV/AIDS and HAART.A five-tree markov model was used to evaluate the quality adjusted life year (QALY) of this HIV screening project and to analyze the related cost effectiveness of the project.Results The cost of HIV screening in Guangxi infectious disease special demonstration project areas was 19.205 million Yuan and having identified 1 218 HIV/AIDS patients.The average costs for HIV/AIDS positive detection in three project countries were 14.562,18.424 and 14.042 thousand Yuan per case.The QALYs gained from finding a HIV/AIDS case were 12.736,8.523 and 8.321 on average,with the total number of QALYs gained from the project as 5 973.184、3 613.752 and 2 704.325.The overall cost effectiveness ratio of the project was 1.562 thousand Yuan per QALY,and 1.143,2.162 and 1.688 thousand Yuan per QALY in these three project countries.Project country "A" showed better cost effectiveness index than country B and C.Conclusion The HIV screening project in Guangxi seemed relatively cost-effective but the average cost of HIV/AIDS positive detection was expensive.To strengthen HAART work for HIV/AIDS could improve the cost-effective of the project.