普遍铅筛查要求：加利福尼亚州案例研究。
Universal Lead Screening Requirement: A California Case Study.
机构信息
Sara B. McMenamin and Troy Melander are with the Department of Family Medicine and Public Health, University of California, San Diego, La Jolla. Sarah P. Hiller is with the Department of Medicine, University of California, San Diego. Erin Shigekawa is with the California Health Benefits Review Program, University of California Office of the President, Oakland. Riti Shimkhada is with the Fielding School of Public Health, University of California, Los Angeles.
出版信息
Am J Public Health. 2018 Mar;108(3):355-357. doi: 10.2105/AJPH.2017.304239. Epub 2018 Jan 18.
OBJECTIVES
To estimate potential impacts of California Assembly Bill (AB) 1316: a requirement for universal screening and insurance coverage for child blood lead testing.
METHODS
In April 2017 the California Health Benefits Review Program (Oakland, CA) analyzed AB 1316 for the California legislature, including a systematic review of lead screening effectiveness, commercial insurer surveys regarding screening coverage, and actuarial utilization and cost implication assessments.
RESULTS
Universal screening requirements would increase child lead testing by 273%, raise affected populations' premiums by 0.0043%, and detect an additional 4777 exposed children 1 year after implementation.
CONCLUSIONS
The evidence for a net societal benefit of universal screening approach is limited and is not supported by prominent medical professional groups. Public Health Implications. California expanded targeted screening to identify additional children at higher risk for lead poisoning on the basis of California-specific risk factors, while mitigating the potential harms of universal screening such as an increase in false positive tests and health care costs.
目的
评估加利福尼亚州议会法案 (AB) 1316 的潜在影响：该法案要求对儿童血铅检测进行普遍筛查和保险覆盖。
方法
2017 年 4 月，加利福尼亚健康福利审查计划（奥克兰，加利福尼亚州）为加利福尼亚州立法机构分析了 AB 1316，包括对铅筛查效果的系统审查、商业保险公司关于筛查覆盖范围的调查，以及精算使用情况和成本影响评估。
结果
普遍筛查要求将使儿童铅检测增加 273%，使受影响人群的保费增加 0.0043%，并在实施后 1 年额外发现 4777 名暴露儿童。
结论
普遍筛查方法对社会净效益的证据有限，也没有得到主要医学专业团体的支持。公共卫生影响。加利福尼亚州根据加利福尼亚州的特定风险因素扩大了有针对性的筛查，以确定更多处于更高铅中毒风险的儿童，同时减轻了普遍筛查可能带来的危害，如假阳性测试和医疗费用的增加。
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