一项促进美籍越南人群宫颈癌筛查项目的成本效益
Cost effectiveness of a program to promote screening for cervical cancer in the Vietnamese-American population.
作者信息
Scoggins John F, Ramsey Scott D, Jackson J Carey, Taylor Victoria M
机构信息
Fred Hutchinson Cancer Research Center, University of Washington, USA.
出版信息
Asian Pac J Cancer Prev. 2010;11(3):717-22.
OBJECTIVES
To conduct a randomized controlled trial to evaluate the cost effectiveness of a lay health worker-administered cervical cancer screening intervention for Vietnamese-American women.
METHODS
The study group included 234 Vietnamese women in the Seattle, Washington area who had not received a Pap test in the last three years. Experimental group participants received a lay health worker home visit. The travel distance and time spent at each visit were recorded. Our trial end-point was Pap smear receipt within six months of randomization. Pap testing completion was ascertained through medical record reviews.
RESULTS
For all Vietnamese women, regardless of their prior history of screening, the cost per intervention was $104.0 (95% CI: $89.6-$118.4). The change in quality-adjusted life days per intervention was 1.26 (95% CI: -5.43-7.96), resulting in an incremental cost-effectiveness ratio (ICER) of $30,015 per quality-adjusted life year. The probability that the ICER exceeds $100,000 is 9.1%.
CONCLUSIONS
The degree of cost effectiveness of such interventions is sensitive to the assumed duration of behavioral change and the participants' prior history of screening.
目的
开展一项随机对照试验，以评估由非专业卫生工作者实施的针对越南裔美国女性的宫颈癌筛查干预措施的成本效益。
方法
研究组包括华盛顿州西雅图地区234名在过去三年未接受巴氏试验的越南女性。实验组参与者接受非专业卫生工作者的家访。记录每次家访的行程距离和花费时间。我们的试验终点是随机分组后六个月内接受巴氏涂片检查。通过查阅病历确定巴氏试验完成情况。
结果
对于所有越南女性，无论其既往筛查史如何，每次干预的成本为104.0美元（95%可信区间：89.6美元至118.4美元）。每次干预的质量调整生命天数变化为1.26（95%可信区间：-5.43至7.96），导致每质量调整生命年的增量成本效益比（ICER）为30,015美元。ICER超过100,000美元的概率为9.1%。
结论
此类干预措施的成本效益程度对行为改变的假定持续时间和参与者既往筛查史敏感。
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