论文部分内容阅读
分 7个不同的年龄组队列 ,比较接种甲型肝炎 (甲肝 )减毒活疫苗 ( H2 株 )后 15年每一队列人群接种与否甲肝感染及发病的差异 ,并根据甲肝患病及甲肝疫苗接种的医疗费用和对质量修正生命年 ( QAL Y)的影响 ,推算接种的费用效果比 ( CER)。不接种情况下推算的不同年龄别人群发病率与本次研究人群的实际资料接近 ,说明计算模型可靠。基础假设的结果显示 ,每获得一个QAL Y,全人口组的平均费用是 152 2 77.60元 ,超过同期人均生产总值的 11倍。各年龄组单位效果的费用变化范围从 113369.30元 ( 10～ 19岁组 )到 2 92 138.30元 (≥ 50岁组 )。但对高危人群接种的分析显示 ,其 CER显著改善。所以 ,甲肝疫苗在中等疫情的城市人群中普遍使用是不合算的 ;预防接种应只面向高危人群。另外 ,灵敏度分析显示主要参数的改变均不会改变本文的结论。
The cohort was divided into seven cohorts of different age groups to compare the differences in the incidence and incidence of hepatitis A in each cohort after 15-year inoculation of attenuated live attenuated hepatitis A vaccine (H2 strain) Vaccination costs and the impact on quality-of-life (QALY) estimates were calculated for cost-effectiveness of vaccination (CER). The estimated incidence of different age groups without vaccination is close to the actual data of this study population, indicating that the calculation model is reliable. The results of the underlying assumptions show that for each QALY received, the average cost of the population-wide population is 152,277.60 yuan, more than 11 times the per capita GDP over the same period. The cost of effectiveness of each age group varies from 113369.30 yuan (10-19 years old group) to 2 92 138.30 yuan (≥ 50 years old group). However, analysis of high-risk population vaccination shows that CERs have significantly improved. Therefore, the universal use of hepatitis A vaccine in urban populations with moderate outbreaks is uneconomical; vaccination should be targeted at high-risk populations only. In addition, the sensitivity analysis shows that the change of the main parameters will not change the conclusion of this paper.