摘要
目的评估我国唐氏综合征产前诊断3种策略的经济学效果。方法采用决策树模型, 对3种策略的费用-效果进行决策分析。结果与不作任何干预的策略相比,仅对35岁以上高风险群体直接作诊断的策略、孕中期筛查后对阳性者作诊断的策略能达到每万名孕妇分别确诊0.93例和1.47例病例,但可能因诊断程序导致正常胎儿流产分别为1.58例和0.82例,每诊断出1例病例的费用分别是108890.98元和443683.11元。结论综合考虑经济效果和安全性因素,孕中期两联筛查后对阳性者作进一步诊断的策略应是优选的策略。
Objective To evaluate the economic effectiveness of three strategies of prenatal diagnosis of Down's syndrome (DS) in China. Methods A decision tree model was used to make a decision analysis on the costeffectiveness of the three strategies. Results As compared with the first strategy of making no interventions, the second strategy of providing direct prenatal diagnosis to high-risk groups(persons aged>35) and the third strategy of providing diagnosis to those tested positive at screenings in mid-term pregnancy could, respectively, lead to the diagnosis of 0.93 and 1.47 cases of DS per 10 thousand pregnant women, but they could also induce, respectively, 1.58 and 0.28 cases of miscarriage of normal fetuses due to diagnosis procedures. The costs of one DS diagnosis were, respectively, 108890.98 yuan and 443683.11 yuan. Conclusion Taking into consideration both cost-effectiveness and safety factors, priority ought to be given to the third strategy.
出处
《中华医院管理杂志》
北大核心
2005年第7期458-461,共4页
Chinese Journal of Hospital Administration
基金
卫生部基金(编号:卫生部基妇发[2003]342号)
