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韩国国民健康筛查计划中高血压筛查的成本效益分析。

Cost-Effectiveness Analysis of Hypertension Screening in the Korea National Health Screening Program.

作者信息

Lee Hae Young, Lee Seung Won, Kim Hyeon Chang, Ihm Sang Hyun, Park Sung Ha, Kim Tae Hyun

机构信息

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.

Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea.

出版信息

Korean Circ J. 2021 Jul;51(7):610-622. doi: 10.4070/kcj.2021.0051. Epub 2021 May 14.

Abstract

BACKGROUND AND OBJECTIVES

To evaluate the cost-effectiveness of routine hypertension (HTN) screening as a part of the national health-screening program.

METHODS

Two aspects of cost-effectiveness were examined using the national general health-screening program. First, the cost of case-finding was computed for 5-year interval age groups. Second, the cost per quality adjusted life years (QALYs) gained were estimated for 12 different scenarios varying examination starting age, pattern and interval compared with no screening.

RESULTS

The cost of finding one new HTN case was low as 26,284 Korean won (KRW) (approximately [approx.] United States Dollar 21) for 70-79 years old to as high as 70,552 KRW for 40-44 years old. Compared with no screening, the costs per QALYs of the following screening strategies were below the incremental cost-effectiveness ratio threshold (approx. KRW 30.5 million): first screening examination with the second confirmatory examination in adults aged ≥40 years every 3 years (KRW 10.2 million), every 2 years (KRW 13.2 million), or annually (KRW 19.9 million). One-way sensitivity analyses suggest that the results were mostly influenced by the sensitivity of the first screening examination, followed by the examination rate of the second confirmatory examination.

CONCLUSIONS

HTN screening as a part of routine national health screening program was cost-effective for adults aged 40 years or older. The most cost-effective HTN screening strategy was the first screening examination with the second confirmatory examination in aged 40 years or older every 3 years.

摘要

背景与目的

评估作为国家健康筛查计划一部分的常规高血压筛查的成本效益。

方法

利用国家一般健康筛查计划对成本效益的两个方面进行了研究。第一,计算了5年间隔年龄组的病例发现成本。第二,与不进行筛查相比,针对12种不同的筛查起始年龄、模式和间隔的情况,估计了每获得一个质量调整生命年(QALY)的成本。

结果

发现一例新高血压病例的成本,70 - 79岁年龄组低至26,284韩元(约21美元),40 - 44岁年龄组高达70,552韩元。与不进行筛查相比,以下筛查策略每QALY的成本低于增量成本效益比阈值(约3050万韩元):≥40岁成年人每3年进行首次筛查检查并进行第二次确诊检查(1020万韩元)、每2年进行一次(1320万韩元)或每年进行一次(1990万韩元)。单因素敏感性分析表明,结果主要受首次筛查检查的敏感性影响,其次是第二次确诊检查的检查率。

结论

作为国家常规健康筛查计划一部分的高血压筛查,对于40岁及以上成年人具有成本效益。最具成本效益的高血压筛查策略是40岁及以上成年人每3年进行首次筛查检查并进行第二次确诊检查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/304e/8263297/a6727bba0ecf/kcj-51-610-g001.jpg

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