Warner Kenneth E, Mendez David, Smith Dean G
Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029, USA.
Inquiry. 2004 Spring;41(1):57-69. doi: 10.5034/inquiryjrnl_41.1.57.
This paper presents results from a simulation of the financial impact and cost effectiveness of smoking cessation in a hypothetical managed care organization (MCO), using data from three large managed care organizations and from existing literature. With base-case assumptions and a market cost of capital, at five years, coverage of cessation services costs an MCO dollars .61 per member per month (PMPM). In a steady-state situation, net cost is dollars .41 PMPM. Both values include altered medical expenditures and MCO revenue patterns attributable to coverage-induced cessation. Quitters gain an average of 7.1 years of life, with a direct coverage cost of dollars 3,417 for each life-year saved. Coverage of cost-effective programs by MCOs should be strongly encouraged.
本文利用来自三个大型管理式医疗组织的数据以及现有文献，展示了在一个假设的管理式医疗组织（MCO）中戒烟的财务影响和成本效益模拟结果。基于基本假设和市场资本成本，在五年时，戒烟服务的覆盖成本为每个成员每月0.61美元（PMPM）。在稳态情况下，净成本为0.41美元PMPM。这两个值都包括因覆盖导致戒烟而改变的医疗支出和MCO收入模式。戒烟者平均多活7.1年，每挽救一个生命年的直接覆盖成本为3417美元。应大力鼓励MCO覆盖具有成本效益的项目。
