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頁籤選單縮合
題名 | Cost-Effectiveness of Elderly Health Examination Program: The Example of Hypertension Screening=老人健康檢查之成本效果:以高血壓檢查為例 |
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作者 | 鄧丙華; 劉宏文; 潘碧珍; 毛莉雯; 邱亨嘉; Deng, Bing-hwa; Liu, Hong-wen; Pan, Pi-chen; Mau, Lih-wen; Chiu, Herng-chia; |
期刊 | The Kaohsiung Journal of Medical Sciences |
出版日期 | 20070100 |
卷期 | 23:1 2007.01[民96.01] |
頁次 | 頁17-24 |
分類號 | 419.45 |
語文 | eng |
關鍵詞 | 成本; 效益; 老人; 高血壓; 中風; Cost; Effectiveness; Elderly; Hypertension; Stroke; |
中文摘要 | 老人健檢施行多年,鮮少有研究嘗試評估其成本效益。本研究之目的在於探討,接受健檢老人高血壓的盛行率與發生率,藉此評估老人健檢計畫中高血壓篩檢的成本與效益。本研究以 25,174 名參與 1996 年健檢計畫、居住於高雄的老年人為研究對象,依據 JNC VI 為標準;採用 1996 及 1997 年的健檢臨床資料,發現高血壓的盛行率及發生率分別為 24.6% 與 6.6%。研究亦呈現罹患高血壓的機率會隨著年紀而顯著增加。相對於未參與健檢計畫者,本研究發現參與計畫的高血壓患者不僅可省下 NT$34,570 至 NT$34,890 的醫療相關成本,且可提升約 128 天的存活期。本研究除了顯示老人健檢計畫具有的成本效益外,並建議高血壓患者危險群應即早接受治療,以降低中風的可能性。最後特別值得注意的是,成本效益分析會因納入評估之指標敏感度與數值不同,而有所差異;故研究結果之詮釋應特別謹慎。 |
英文摘要 | The National Health Insurance (NHI) and social welfare agencies have implemented the Elderly Health Examination Program (EHEP) for years. No study has ever attempted to evaluate whether this program is cost-effective. The purposes of this study were, firstly, to understand the prevalence and incidence rates of hypertension and, secondly, to estimate the cost and effectiveness of the EHEP, focusing on hypertension screening. The data sources were: (1) hypertension and clinical information derived from the 1996 and 1997 EHEP, which was used to generate prevalence and incidence rates of hypertension; and (2) claim data of the NHI that included treatment costs of stroke patients (in- and outpatients). Hypothetical models were used to evaluate the cost-effectiveness of the hypertension screening program in various conditions. Sensitivity analysis was also employed to evaluate the effect of each estimation indicator on the cost and effectiveness of the hypertension screening program. A total of 28.3% of the elderly population in Kaohsiung (25,174 of 88,812) participated in the 1996 EHEP; 14,915 of them participated in the following 1997 EHEP, with a retention rate of 59.3%. Criteria from the Sixth Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI) (systolic blood pressure/diastolic blood pressure ≥ 160/95 mmHg or taking antihypertensive drugs) were used; we found that prevalence and incidence rates of hypertension were 24.6% and 6.6%, respectively. Hypertension rates are increasing in the aging process as shown in both prevalence and incidence models. In comparison with non-participants, the prevalence model indicates that each hypertension patient who had attended the EHEP not only saved NT$34,570–34,890 in medical and associated costs, but also increased their lifespan by 128 days. The present findings suggest that the EHEP is a cost-effective program with health and social welfare policy implications. With the relatively low participation rate of the EHEP, health and social agencies need to put more effort into the promotion of this free health examination program to attract potential participants. In doing so, the population at risk for hypertension would be identified for early treatment, and the probability of having stroke could be decreased. Consequently, health care expenditures for treatment and caregiving of stroke patients would be minimized. Finally, it should be noted that the sensitivity and values of selected parameters can modify the results of cost-effectiveness analysis. Interpretations of the effects of prevention services on costs and effectiveness need to be treated with caution. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。