越南高血压控制社区干预的成本效益分析

Viet Nguyen, D. Ha, O. M. Tran, Hoa L. Nguyen, Robert J. Goldberg, J. Allison, Neil S. Fleming, Phuong Khanh Nguyen
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摘要

摘要 2010 年至 2011 年间,针对越南洪燕省日益严重的高血压失控问题,各利益相关方实施了一项以社区为基础的多方面干预措施。这项措施将扩大社区保健员服务、家庭血压自我监测和独特的 "讲故事干预 "纳入常规临床护理。从有限的社会角度出发,我们的研究使用马尔可夫模型评估了这一干预措施的成本效益。基于 671 名患者的队列分析显示,每获得一个质量调整生命年(QALY)的终生增量成本约为 9,037 万越南盾(3,930 美元)。由于支付意愿为国内生产总值的三倍(每质量调整生命年 2.592 亿越南盾),因此该干预措施在 80% 的情况下具有成本效益。这项研究强调了以社区为基础的方法在有效控制高血压方面的潜力,为其对公共卫生的广泛影响提供了宝贵的见解。
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Cost-utility analysis of community-based interventions for hypertension control in Vietnam
Abstract Between 2010 and 2011, stakeholders implemented a multi-faceted community-based intervention in response to the escalating issue of uncontrolled hypertension in Hung Yen province, Vietnam. This initiative integrated expanded community health worker services, home blood pressure self-monitoring, and a unique "storytelling intervention" into routine clinical care. From the limited societal perspective, our study evaluates the cost-effectiveness of this intervention using a Markov model with a one-year cycle over a lifetime horizon. The analysis, based on a cohort of 671 patients, reveals a lifetime incremental cost of approximately VND 90.37 million (USD 3,930) per quality-adjusted life year (QALY) gained. With a willingness to pay at three times GDP (VND 259.2 million per QALY), the intervention proves cost-effective 80% of the time. This research underscores the potential of the community-based approach to effectively control hypertension, offering valuable insights into its broader implications for public health.
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