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[初级卫生保健中戒烟健康咨询的成本效益]

[Cost-effectiveness of antismoking health counselling in primary health care].

作者信息

Comas Fuentes A, Suárez Gutiérrez R, López González M L, Cueto Espinar A

机构信息

Centro de Salud de Otero, Oviedo.

出版信息

Gac Sanit. 1998 May-Jun;12(3):126-32. doi: 10.1016/s0213-9111(98)76457-x.

Abstract

OBJECTIVE

To study the cost-effectiveness of simple anti-smoking advice in Primary health care.

METHODS

We accomplish a cost-effectiveness analysis in the area of the Primary health care. As efficiency of the advice we use own results. To evaluate the smoking cessation we base on vital tables of the "25-State Cancer Prevention Study", discounted to the 5%. The costs have been calculated as of the tariffs used for services billing lent in primary health centers to not beneficiary of the social security. It was accomplished a sensibility analysis on different aspects with possible influence on the result.

RESULTS

The cost-effectiveness oscillated between 67,621 and 89,619 pesetas by year of life saved for the men and between 116,225 and 137,748 pesetas for the women, in function of the age. The relationship most favorable, for both sexes, it is between 45 and 54 years. In the group of 35 to 39 years, for the physicians, was of 89,419 and 163,934 pesetas for men and women respectively, and for the nursing personnel was oscillating between 43,955 and 81,523, for men; and between 80,584 and 149,460 pesetas for women in function of the considered salary.

CONCLUSIONS

It is an intervention with a very favorable relationship cost-effectiveness, at least, comparable to that of other customarily accepted preventive measures. The nursing advice is less effective that the physician advice, but it is, at least, equal of efficient in terms of cost by year of life saved.

摘要

目的

研究基层医疗保健中简单戒烟建议的成本效益。

方法

我们在基层医疗保健领域进行了成本效益分析。建议的效果采用我们自己的研究结果。评估戒烟情况时,我们以“25个州癌症预防研究”的生命表为基础,并按5%进行贴现。成本是根据基层医疗中心用于服务计费的费率计算得出的,针对的是没有社会保障福利的人群。我们对可能影响结果的不同方面进行了敏感性分析。

结果

根据年龄不同,男性每挽救一年生命的成本效益在67,621至89,619比塞塔之间,女性在116,225至137,748比塞塔之间。对两性而言,最有利的年龄区间是45至54岁。在35至39岁组中,对于医生来说,男性的成本效益为89,419比塞塔,女性为163,934比塞塔;对于护理人员来说,男性的成本效益在43,955至81,523比塞塔之间,女性在80,584至149,460比塞塔之间,具体取决于所考虑的薪资水平。

结论

这是一种成本效益关系非常有利的干预措施,至少与其他通常被接受的预防措施相当。护理人员提供的建议效果不如医生,但就每挽救一年生命的成本而言,至少效率相当。

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