马来西亚卫生部透析项目的成本效益评估。

Cost effectiveness evaluation of the Ministry of Health Malaysia dialysis programme.

作者信息

Lim T O, Lim Y N, Wong H S, Ahmad G, Singam T S, Morad Z, Suleiman A B, Rozina G, Ong L M, Hooi L S, Shaariah W, Tan C C, Loo C S

机构信息

Department of Nephrology, Hospital Kuala Lumpur.

出版信息

Med J Malaysia. 1999 Dec;54(4):442-52.

PMID:11072461

Abstract

We determine the cost effectiveness of centre and home haemodialysis (HD), continuous ambulatory peritoneal dialysis (CAPD) and intermittent peritoneal dialysis (IPD) treatment in the Ministry of Health (MOH) programme. The viewpoint taken for this evaluation is that of MOH. Cost categories identified were capital cost, dialysis operational cost, medical cost and general hospital cost. Cost estimates were mostly based on actual resource utilisation. Life years saved were estimated based on Dialysis Registry data on 2480 HD and 732 CAPD patients. Overall, the cost-effectiveness ratio (CER) of centre HD was RM21620/life year saved. Those of home HD, CAPD and IPD were RM23375, RM30469 and RM36016 respectively. Sensitivity analyses did not change the ranking of the CER. We conclude the MOH dialysis programme was cost-effective, and among the various dialysis modalities centre HD was the most cost-effective.

摘要

我们确定了卫生部项目中中心血液透析（HD）、家庭血液透析、持续性非卧床腹膜透析（CAPD）和间歇性腹膜透析（IPD）治疗的成本效益。本次评估所采用的视角是卫生部的视角。确定的成本类别包括资本成本、透析运营成本、医疗成本和综合医院成本。成本估算大多基于实际资源利用情况。挽救的生命年数是根据2480名血液透析患者和732名持续性非卧床腹膜透析患者的透析登记数据估算得出的。总体而言，中心血液透析的成本效益比（CER）为每挽救一个生命年21620马来西亚林吉特。家庭血液透析、持续性非卧床腹膜透析和间歇性腹膜透析的成本效益比分别为23375、30469和36016。敏感性分析并未改变成本效益比的排名。我们得出结论，卫生部的透析项目具有成本效益，在各种透析方式中，中心血液透析是最具成本效益的。