塞拉利昂埃博拉病毒病疫情早期应对的成本与效益
Costs and benefits of early response in the Ebola virus disease outbreak in Sierra Leone.
作者信息
Kellerborg Klas, Brouwer Werner, van Baal Pieter
机构信息
Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
出版信息
Cost Eff Resour Alloc. 2020 Mar 16;18:13. doi: 10.1186/s12962-020-00207-x. eCollection 2020.
BACKGROUND
The 2014-2016 Ebola virus disease (EVD) outbreak in West Africa was the largest EVD outbreak recorded, which has triggered calls for investments that would facilitate an even earlier response. This study aims to estimate the costs and health effects of earlier interventions in Sierra Leone.
METHODS
A deterministic and a stochastic compartment model describing the EVD outbreak was estimated using a variety of data sources. Costs and Disability-Adjusted Life Years were used to estimate and compare scenarios of earlier interventions.
RESULTS
Four weeks earlier interventions would have averted 10,257 (IQR 4353-18,813) cases and 8835 (IQR 3766-16,316) deaths. This implies 456 (IQR 194-841) thousand DALYs and 203 (IQR 87-374) million $US saved. The greatest losses occurred outside the healthcare sector.
CONCLUSIONS
Earlier response in an Ebola outbreak saves lives and costs. Investments in healthcare system facilitating such responses are needed and can offer good value for money.
背景
2014 - 2016年西非埃博拉病毒病（EVD）疫情是有记录以来最大规模的埃博拉疫情，这引发了对有助于更早做出应对的投资的呼吁。本研究旨在估算在塞拉利昂更早进行干预的成本和健康影响。
方法
使用多种数据源估计了一个描述埃博拉疫情的确定性和随机性 compartment 模型。成本和伤残调整生命年用于估计和比较更早进行干预的情景。
结果
提前四周进行干预可避免10257例（四分位间距4353 - 18813）病例和8835例（四分位间距3766 - 16316）死亡。这意味着节省45.6万（四分位间距19.4 - 84.1万）伤残调整生命年和2.03亿美元（四分位间距8700万 - 3.74亿美元）。最大的损失发生在医疗保健部门之外。
结论
在埃博拉疫情中更早做出应对可挽救生命并降低成本。需要对有助于做出此类应对的医疗保健系统进行投资，并且这些投资可以物有所值。
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