本文關(guān)鍵詞： 麻疹 麻疹疫苗 成本-效果 成本-效益 社會(huì)效益 經(jīng)濟(jì)效益　出處：《新疆醫(yī)科大學(xué)》2007年碩士論文　論文類型：學(xué)位論文

【摘要】： 背景:麻疹是一種嚴(yán)重危害兒童健康的急性呼吸道傳染病,患病后易發(fā)生嚴(yán)重的并發(fā)癥,迄今仍是低齡兒童中疫苗可預(yù)防性傳染病導(dǎo)致死亡的首要原因之一。包括我國在內(nèi)的世界衛(wèi)生組織西太平洋區(qū)域每年大約有3萬名兒童死于麻疹。因此其危害在疫苗可預(yù)防疾病中仍占有重要地位。目前WHO已將麻疹定為繼天花、脊髓灰質(zhì)炎之后的第三個(gè)將被消除或消滅的疾病,2005年我國所在的WHO西太平洋區(qū)所有國家承諾到2012年消除麻疹。中國于1965年開始應(yīng)用麻疹疫苗,特別是1978年開展計(jì)劃免疫后,麻疹發(fā)病已得到有效控制。但是,部分省(市、區(qū))常規(guī)免疫的滑坡導(dǎo)致近幾年麻疹發(fā)病率在我國重新抬頭。1999-2001年,全國麻疹病例每年都以20%以上的速度增加。我區(qū)麻疹發(fā)病率在全國32個(gè)省(市、區(qū))中占第二位,是造成全國麻疹發(fā)病率上升的主要貢獻(xiàn)者之一。2004年在我區(qū)范圍內(nèi)出現(xiàn)了麻疹暴發(fā)或流行,導(dǎo)致2004年麻疹報(bào)告發(fā)病率上升為34/10萬,躍居全國首位。針對這種態(tài)勢,在衛(wèi)生部和自治區(qū)人民政府的大力支持下,2004年11月25日至12月1日,在全區(qū)范圍內(nèi)對8月齡至13歲兒童成功地實(shí)施了一輪麻疹強(qiáng)化免疫。其接種范圍之廣、接種兒童數(shù)量之多、投入人力物力之大,在我區(qū)是史無前例的。對于實(shí)行的任何一項(xiàng)衛(wèi)生規(guī)劃,我們在關(guān)注其所能帶來的社會(huì)效益的同時(shí),也應(yīng)該重視其所能產(chǎn)生的經(jīng)濟(jì)效益。這就需要對每一項(xiàng)衛(wèi)生策略進(jìn)行經(jīng)濟(jì)學(xué)評價(jià),評價(jià)的結(jié)果對衛(wèi)生決策部門合理、高效的利用有限衛(wèi)生資源具有重要的指導(dǎo)意義。本研究欲從衛(wèi)生經(jīng)濟(jì)學(xué)角度對我區(qū)麻疹疫苗強(qiáng)化免疫預(yù)防策略進(jìn)行社會(huì)和經(jīng)濟(jì)效益方面的研究,定量了解我區(qū)麻疹強(qiáng)化免疫的投入情況以及所產(chǎn)生的社會(huì)效益和經(jīng)濟(jì)效益,全面考慮強(qiáng)化免疫策略的經(jīng)濟(jì)性,通過數(shù)據(jù)顯示預(yù)防接種在經(jīng)濟(jì)建設(shè)中的作用,為政府制定和完善免疫策略、保證衛(wèi)生資源的優(yōu)化配置提供依據(jù)。 目的:對我區(qū)麻疹疫苗強(qiáng)化免疫預(yù)防策略進(jìn)行系統(tǒng)的衛(wèi)生經(jīng)濟(jì)學(xué)評價(jià)。評價(jià)的結(jié)果有利于指導(dǎo)麻疹免疫預(yù)防策略的調(diào)整和完善,有利于有限衛(wèi)生資源得以優(yōu)化配置。 方法:采用衛(wèi)生經(jīng)濟(jì)學(xué)評價(jià)方法進(jìn)行分析。本課題以我區(qū)2004年麻疹疫苗強(qiáng)化免疫活動(dòng)為背景,采用以下研究路線進(jìn)行研究。(1)根據(jù)我區(qū)2004年麻疹強(qiáng)化免疫活動(dòng)的硬件投入和軟件投入費(fèi)用,計(jì)算出我區(qū)2004年麻疹強(qiáng)化免疫的成本;(2)結(jié)合強(qiáng)化免疫前后麻疹報(bào)告發(fā)病率,推算出我區(qū)實(shí)施麻疹強(qiáng)化免疫后減少的發(fā)病人數(shù),此即為我區(qū)麻疹強(qiáng)化免疫預(yù)防策略獲得的社會(huì)效益;(3)選擇我區(qū)2004年麻疹患者作為經(jīng)濟(jì)效益研究的對象人群,計(jì)算其因感染麻疹所引起的直接、間接經(jīng)濟(jì)損失。進(jìn)而結(jié)合麻疹強(qiáng)化免疫后減少的發(fā)病人數(shù),推算出我區(qū)因?qū)嵤┞檎顝?qiáng)化免疫可避免的各種經(jīng)濟(jì)損失,此即為我區(qū)麻疹強(qiáng)化免疫預(yù)防策略獲得的經(jīng)濟(jì)效益;(4)運(yùn)用衛(wèi)生經(jīng)濟(jì)學(xué)評價(jià)中的成本-效果、成本-效益分析方法評價(jià)我區(qū)麻疹強(qiáng)化免疫預(yù)防策略的經(jīng)濟(jì)和社會(huì)效益。 結(jié)果:2004年我區(qū)麻疹疫苗強(qiáng)化免疫投入的成本共計(jì)1042萬元;麻疹患者的直接經(jīng)濟(jì)損失為4031元,間接經(jīng)濟(jì)損失為600元;強(qiáng)化免疫后的兩年半內(nèi)有9705人免于發(fā)生麻疹,獲得的直接經(jīng)濟(jì)效益為4071.84萬元,間接經(jīng)濟(jì)效益為606.58萬元,總效益為4678.42萬元;麻疹疫苗強(qiáng)化免疫策略的總BCR值為4.49,凈效益值為3636.42萬元,說明該策略獲得了很好的經(jīng)濟(jì)效益和社會(huì)效益。 結(jié)論:我區(qū)實(shí)行的麻疹疫苗強(qiáng)化免疫策略,其效益-成本值遠(yuǎn)大于1,說明在該項(xiàng)措施上進(jìn)行投資取得了遠(yuǎn)遠(yuǎn)超過成本的經(jīng)濟(jì)效益,因此我區(qū)2004年麻疹強(qiáng)化免疫預(yù)防策略具有經(jīng)濟(jì)學(xué)上的可行性。麻疹強(qiáng)化免疫的效益-成本值是動(dòng)態(tài)變化的,我們應(yīng)對其做出長期動(dòng)態(tài)評價(jià),推進(jìn)預(yù)防接種工作,更高效地預(yù)防和控制麻疹的傳播,更有效地利用有限的衛(wèi)生資源。
[Abstract]:Background: measles is an acute respiratory infectious disease seriously endangering children's health, illness prone to serious complications, so far is still young children in the vaccine preventable diseases caused the death of one of the primary reasons. There are about 30 thousand children died of measles in China including the West Pacific Regional WHO each year. So the harm can still play an important role in disease prevention in the vaccine. Now WHO has been set for measles after smallpox, polio after the third would be to eliminate or eradicate the disease, in 2005 China where the WHO West Pacific region all countries committed to the elimination of measles in 2012. Chinese began in 1965 of the measles vaccine, especially in 1978 after immunization, measles incidence has been effectively controlled. However, part of the province (city, district) routine immunization landslides in recent years, the incidence of measles in our country The rise of.1999-2001 years, the measles cases annually increasing at a rate of more than 20%. The incidence of measles in our region in 32 provinces (cities, districts) accounted for second, which is the main contribution of the increased incidence of measles among the.2004 in my area had measles outbreak, resulting in 2004 the reported incidence of measles rose 34/10 million, ranked first in the country. In view of this situation, in support of the Ministry of health and the autonomous region of the people's government, from November 25, 2004 to December 1st, in the region of 8 month old to 13 year olds successfully implemented a measles immunization. The breadth of its coverage, the number of children vaccinated. More investment in human resources is large, in my area. There was no parallel in history. for any health plan implementation, we can bring attention to their social benefits at the same time, should also pay attention to their produce economic Benefit. This needs to carry on economic evaluation of each health strategy, the evaluation results of the health decision-making department is reasonable, has an important guiding significance to the efficient use of limited health resources. For this study from the perspective of health economics Xinjiang measles vaccine immunization for the prevention of social and economic benefits in terms of strategy, quantitative understanding of the input region measles immunity and the social and economic benefits, comprehensive consideration of strengthening economic immunity strategy, through the data show that the preventive effect of vaccination in economic construction, for the government to formulate and improve immunization strategy, ensure the basis for optimizing the allocation of health resources.
Objective: To evaluate the preventive strategies of measles vaccine in our district systematically and hygienic economics. The results of the evaluation are helpful to guide the adjustment and improvement of measles immunization strategy, and to optimize the allocation of limited health resources.
Methods: the evaluation of health economics analysis. In this paper I 2004 measles immunization activities as the background, the following line of research. (1) according to the hardware and software investment in our region in 2004 measles immunization activities cost calculated in our region in 2004 measles immunization costs; (2) combining the measles immune reporting rate before and after the projected implementation of the incidence of measles immunization reduced in our region, namely Xinjiang measles vaccination strategy to strengthen the social benefits; (3) selection of measles in Xinjiang in 2004 as the economic benefits of target groups, calculated from the measles infection caused by the direct the incidence, indirect economic loss. Then after immunization with the measles reduction, I calculate the area due to various economic loss of measles immunization can be avoided, this is my area The economic benefits of measles intensified immunization strategy were achieved. (4) the cost-effectiveness analysis and cost-benefit analysis method were used to evaluate the economic and social benefits of measles immunization strategy in our area.
Results: in 2004 the measles vaccine immunization total investment cost of 10 million 420 thousand yuan; the direct economic loss of measles patients is 4031 yuan and the indirect economic loss of 600 yuan; immunization after two and a half years with 9705 people from measles, the direct economic benefit of 40 million 718 thousand and 400 yuan, the indirect economic benefit is 6 million 65 thousand and 800 yuan, the total the benefit is 46 million 784 thousand and 200 yuan; measles vaccine strengthening immunization strategy of the total BCR value is 4.49, the net benefit was 36 million 364 thousand and 200 yuan, indicating that the strategy was a good economic and social benefits.
Conclusion: measles vaccine immunization strategy in our region to implement, the benefit cost is greater than 1, the investment in the measure has been far more than the cost of economic benefits, so I in 2004 to strengthen measles immunization strategy for the prevention of the feasibility of economics. Measles immunization costs is the effectiveness of dynamic change, we should make its long-term dynamic evaluation, promote vaccination, dissemination of more efficient prevention and control of measles, more effective use of limited health resources.

【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2007
【分類號】：R186

【引證文獻(xiàn)】

相關(guān)碩士學(xué)位論文 前1條

1 鄭敬彤;長春地區(qū)麻疹野毒株H基因與F基因變異情況及流行病學(xué)研究[D];吉林大學(xué);2012年

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本文編號：1495091