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目的分析番禺区结核病的疾病负担及省项目的控制效果,同时比较流动人口和常住人口结核病的个人负担。方法采用抽样电话调查结合病历回顾的方法估计个人成本,运用伤残调整寿命年(DALY)指标及成本效果分析等经济学方法来评价项目实施效果。结果平均治愈1例传染性肺结核病人需社会成本7115元,其中机构成本3996元,个人成本为3119元;常住人口的个人成本为2438元,流动人口的个人成本为3906元;结核病导致的健康寿命损失为0.2288人年/1000人,男性为0.3004人年/1000人,女性为0.1605人年/1000人。20～45岁的劳力人群的DALY占了整个DALY的76%;每治愈1例常住人口肺结核病人的社会成本为6434元,流动人口为7902元,常住人口每发现1例肺结核病人的机构成本为513.1元,流动人口为1760.0元。项目投入产出比为1:39.6。结论流动人口结核病的个人支出较常住人口高;因结核病造成的寿命损失男性高于女性,20～45岁劳力人群受疾病影响的主要人群;流动人口结核病的发现成本、治愈成本均比常住人口高。该项目的成本效益收益明显。
Objective To analyze the disease burden of TB in Panyu District and the control effect of provincial projects, and to compare the individual burden of TB in floating population and resident population. Methods A sample telephone survey was conducted to estimate the individual cost in combination with the medical record review. The DALY index and the cost-effectiveness analysis were used to evaluate the implementation effect of the project. Results The average social cost of treating one case of infectious pulmonary tuberculosis was 7,115 yuan, of which the agency cost was 3996 yuan and the individual cost was 3119 yuan. The permanent cost of the resident population was 2,438 yuan and the individual cost of the floating population was 3,906 yuan. The healthy life span caused by tuberculosis Losses were 0.2288 person-years / 1000 persons, 0.3004 men / 1000 men and 0.1605 women / 1000 persons. The DALY of working-age people aged 20-45 accounted for 76% of the total DALY. The social cost of treating 1 permanent pulmonary tuberculosis patient was 6,434 yuan and the floating population was 7,902 yuan. The cost per 1 resident tuberculosis found in the permanent population was 513.1 yuan, the floating population of 1760.0 yuan. Project input-output ratio of 1: 39.6. Conclusion The personal expenditure of floating population is higher than that of the resident population. The loss of life expectancy due to tuberculosis is higher than that of the female and the main population affected by the disease is 20-45 year-old labor force. The detection cost and cure cost of floating population are higher than the resident population . The cost benefit of this project is obvious.