Glotzer D E, Bauchner H, Freedberg K A, Palfrey S
Department of Pediatrics, Boston City Hospital, MA 02118.
Am J Public Health. 1994 Jan;84(1):110-2. doi: 10.2105/ajph.84.1.110.
Decision analysis was used to compare the costs of three screening strategies for childhood lead poisoning: (1) venipuncture; (2) capillary sample with venipuncture confirmation if the blood lead level is elevated; (3) stratification by risk, with venipuncture for high-risk children and capillary sample for low-risk children. Under baseline conditions, the cost of screening by the venipuncture, stratification, and capillary strategies is $22, $25, and $27, respectively. Venipuncture remains the least expensive strategy unless the cost of venipuncture is more than three times that of capillary sampling. The annual cost of a national lead screening program that uses a single venipuncture sample would be $352 million. Initial screening with a capillary sample would cost $432 million, 23% more than venipuncture.
（1）静脉穿刺；（2）若血铅水平升高，则采用毛细血管采样并通过静脉穿刺进行确认；（3）按风险分层，高危儿童采用静脉穿刺，低危儿童采用毛细血管采样。在基线条件下，静脉穿刺、分层和毛细血管采样策略的筛查成本分别为22美元、25美元和27美元。除非静脉穿刺的成本超过毛细血管采样成本的三倍，否则静脉穿刺仍是成本最低的策略。使用单次静脉穿刺样本的全国性铅筛查项目的年度成本将为3.52亿美元。最初采用毛细血管采样进行筛查的成本将为4.32亿美元，比静脉穿刺高出23%。
