Sagmeister M, Gessner U, Kind C, Horisberger B
Forschungsgruppe für Management im Gesundheitswesen, Hochschule St. Gallen.
Schweiz Med Wochenschr Suppl. 1995;65:103S-112S.
A comprehensive cost-benefit analysis of possible screening strategies for congenital toxoplasmosis is necessary as a basis for the decision whether or not screening is efficient and socially desirable. The total costs of the disease in Switzerland were calculated for the year 1990. Direct costs (all diagnostic and therapeutic interventions, including care of handicapped children) and indirect costs (partial and total work losses in the future) were taken into account. Today, the direct costs amount to approx. SFr. 20 mio per year (i.e. approx. SFr. 2.8 mio per million population). The indirect costs were calculated at SFr. 4 mio per year. Moreover, the costs incurred with three possible screening programs (1 test with all pregnant women, with 1, 2 or 5 additional tests, depending on the strategy) were estimated, together with the concomitant cost savings. The financial resources needed for the screenings would amount to SFr. 7 mio-18 mio per year, depending on the strategy chosen. However, the possible savings would be in the range of SFr. 4 mio-12 mio only. The possible savings are, in any case, of the same order of magnitude as the costs for screening. Screening would become cost-efficient if costs for the serological tests could be lowered.
对先天性弓形虫病可能的筛查策略进行全面的成本效益分析是必要的,以此作为判断筛查是否有效及是否符合社会需求的决策依据。计算了1990年瑞士该病的总成本,其中考虑了直接成本(所有诊断和治疗干预措施,包括对残疾儿童的照料)和间接成本(未来部分和全部的工作损失)。如今,直接成本约为每年2000万瑞士法郎(即每百万人口约280万瑞士法郎),间接成本计算为每年400万瑞士法郎。此外,还估算了三种可能的筛查方案(对所有孕妇进行1次检测,根据策略再增加1次、2次或5次检测)的成本以及相应的成本节省情况。根据所选策略,筛查所需的财政资源每年将达700万至1800万瑞士法郎。然而,可能的节省仅在400万至1200万瑞士法郎之间。无论如何,可能的节省与筛查成本处于同一数量级。如果血清学检测成本能够降低,筛查将变得具有成本效益。