关键词: 结核,肺, 国家卫生规划, 费用效益分析, 评价研究, 对比研究

Abstract:

Objective: To evaluate the social benefits generated by the funding for tuberculosis prevention and control from 2011 to 2020 in Sichuan Province, and to provide evidence for the development of medium- and long-term development plans for the new era. Methods: Retrospective study method was used to collect the treatment outcomes of smear positive pulmonary tuberculosis patients and the proportion of working population among pulmonary tuberculosis patients from 2011 to 2020 (during the 12th Five-Year and the 13th Five-Year plan of National Tuberculosis and Control Program (NTP)) in Sichuan Province from the Tuberculosis Management Information System and the Monitoring of Infections Diseases System, and to collect funding data and gross domestic product (GDP) from the Sichuan Statistical Yearbook and the self-assessment questionnaire of the final evaluation of NTP implementation. The social effect, social utility and social benefit of tuberculosis prevention and control funds investment in the past 10 years were estimated using three analysis methods commonly used in health economics: cost-effectiveness, cost-utibility and cost-benefit. At the same time, the estimated results of the 12th Five-Year Plan and the 13th Five-Year Plan were compared and analyzed. Results: From 2011 to 2020, 760.326 million yuan were invested for tuberculosis prevention and control in Sichuan Province, and 160167 smear positive pulmonary tuberculosis patients were successfully treated, which prevented 696899 healthy individuals from tuberculosis infection and 1155277 disability adjusted life years (DALY) were saved. It saved 605 million yuan of medical expenses and 37.032 billion yuan of social and economic losses. 1091.01 yuan were needed to avoid a healthy person to be infected,and 658.13 yuan needed to save 1 DALY. Additional investment of 1 yuan can produce 49.50 yuan of economic benefits. The total social benefits (20.922 billion yuan) brought by the 13th Five-Year Plan increased by 25.18% ((209.22-167.14)/167.14) compared with the 12th Five-Year Plan (16.714 billion yuan), but the social benefits (47.56 yuan) brought by the government investment of one yuan for tuberculosis prevention and control decreased by 4.61 yuan compared with that of 52.17 yuan during the 12th Five-Year Plan period. Conclusion: From 2011 to 2020, the investment of governments at all levels and international projects invested in tuberculosis prevention and control in Sichuan has produced good social effects, effectiveness and benefits. It is recommended that, while maintaining the current level of funding, governments at all levels continue to increase their investment, especially in areas of case detection and treatment management of pathogen positive patients in order to achieve higher social benefits.

Key words: Tuberculosis, pulmonary, National health programme, Cost-benefit analysis, Evaluation studies, Comparative study