COVID-19:美国社会干预政策对健康和经济的影响

Alireza Boloori, S. Saghafian
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引用次数: 2

摘要

事实证明,居家令等干预政策对控制2019年新型冠状病毒病(COVID-19)的传播是有效的。然而,对这些政策带来的经济负担的担忧促使美国各州朝着重新开放的方向迈进。大多数州的决策一直具有挑战性,特别是因为缺乏关于不同干预政策的健康收益与经济负担的定量证据。为了帮助决策者,我们利用了来自美国51个州的各种因素的详细数据,包括检查次数、阳性和阴性结果、住院情况、ICU床位和使用的呼吸机、居民的流动性和死亡,并提供了一个分析框架来衡量在各种干预政策下的人均总成本与质量调整生命年(QALY)。我们的研究结果表明,与假设2020年3月至6月期间不进行干预相比,美国各地采取的政策平均为每个人节省了4.04天的QALY,同时为他/她产生了3284.67美元。如果各州在同一时间段内采取了比他们采取的更严格的政策,那么平均质量和人均成本的增加将分别达到6天和4,953.81美元。我们还发现,在典型的支付意愿率下,更严格的政策并不具有成本效益。然而,在不久的将来,实施这种严格的政策可能是不可避免的,特别是如果第二波新冠肺炎的风险增加的话。最后,除了量化干预政策的健康和经济影响外,我们的结果还允许联邦和州当局避免遵循“一刀切”的策略,而是制定更适合每个州的政策。
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COVID-19: Health and Economic Impacts of Societal Intervention Policies in the U.S.
Intervention policies, like stay-at-home orders, are shown to be effective in controlling the spread of the novel Coronavirus Disease 2019 (COVID-19). However, concerns over economic burdens of these policies have propelled U.S. states to move towards reopening. Decision-making in most states has been challenging, especially because of a dearth of quantitative evidence on health gains versus economic burdens of different intervention policies. To assist decision-makers, we make use of detailed data from 51 U.S. states on various factors, including number of tests, positive and negative results, hospitalizations, ICU beds and ventilators used, residents' mobility, and deaths, and provide an analytical framework to measure per capita total costs versus quality-adjusted life years (QALY) under various intervention policies. Our results show that, compared to a hypothetical no intervention during March-June 2020, the policies undertaken across the U.S. on average saved each person up to 4.04 days worth of QALY while incurring $3,284.67 for him/her. Had the states undertaken more strict policies during the same time frame than those they adopted, the increase in the average QALY and cost per person would be up to 6 days and $4,953.81, respectively. We also find that stricter policies are not cost-effective at the typical willingness-to-pay rates. Imposing such strict policies, however, may be inevitable in the near future, especially if the risk of a second wave of COVID-19 increases. Finally, in addition to quantifying the health and economic impacts of intervention policies, our results allow federal and state authorities to avoid following a “one-size-fits-all" strategy, and instead enact policies that are better suited for each state.
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