墨西哥社会保障局宫颈癌筛查项目的成本
Cost of the Cervical Cancer Screening Program at the Mexican Social Security Institute.
作者信息
Granados-García Víctor, Flores Yvonne N, Pérez Ruth, Rudolph Samantha E, Lazcano-Ponce Eduardo, Salmerón Jorge
机构信息
Unidad de Investigación Epidemiológica y en Sistemas de Salud, Área de envejecimiento, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, Distrito Federal, México.
Coordinación Delegacional de Abastecimiento y Equipamiento, Delegación Morelos, Instituto Mexicano del Seguro Social, México, Distrito Federal, México.
出版信息
Salud Publica Mex. 2014 Sep-Oct;56(5):502-10. doi: 10.21149/spm.v56i5.7375.
OBJECTIVE
To estimate the annual cost of the National Cervical Cancer Screening Program (CCSP) of the Mexican Institute of Social Security (IMSS).
MATERIALS AND METHODS
This cost analysis examined regional coverage rates reported by IMSS. We estimated the number of cytology, colposcopy, biopsy and pathology evaluations, as well as the diagnostic test and treatment costs for cervical intraepithelial neoplasia grade II and III (CIN 2/3) and cervical cancer. Diagnostic test costs were estimated using a micro-costing technique. Sensitivity analyses were performed.
RESULTS
The cost to perform 2.7 million cytology tests was nearly 38 million dollars, which represents 26.1% of the total program cost (145.4 million). False negatives account for nearly 43% of the program costs.
CONCLUSION
The low sensitivity of the cytology test generates high rates of false negatives, which results in high institutional costs from the treatment of undetected cervical cancer cases.
目的
估算墨西哥社会保障局（IMSS）国家宫颈癌筛查计划（CCSP）的年度成本。
材料与方法
本成本分析考察了IMSS报告的区域覆盖率。我们估算了细胞学、阴道镜检查、活检和病理评估的数量，以及宫颈上皮内瘤变II级和III级（CIN 2/3）和宫颈癌的诊断检测及治疗成本。诊断检测成本采用微观成本核算技术估算。进行了敏感性分析。
结果
进行270万次细胞学检测的成本近3800万美元，占项目总成本（1.454亿美元）的26.1%。假阴性病例几乎占项目成本的43%。
结论
细胞学检测的低敏感性导致假阴性率较高，这使得未检测出的宫颈癌病例的治疗产生了高昂的机构成本。
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