| ObjectiveBased on the rate of hepatitis B vaccination in Beijing,by comparing the changes of the positive rate of HBsAg and the incidence of hepatitis B in the population,and the correlation between the index and the cost.The purpose of this study is to analyze the cost effectiveness of the immunization strategies and measures of hepatitis B vaccine for more than 20 years in Beijing.It provides the basis for Beijing municipal government to optimize the prevention and control policy,strategy and prevention and control measures of hepatitis B in Beijing.ContentsThis study mainly takes the cost of hepatitis B vaccination as a cost index.The results of this study include the positive rate of hepatitis B surface antigen,the reported incidence of hepatitis B,the incidence of chronic hepatitis B,the incidence of acute hepatitis B,the incidence of hepatitis B cirrhosis,and the incidence of hepatitis B liver cancer.The cost effectiveness analysis includes the cost effect ratio,the incremental cost effect ratio and the marginal effect analysis.The specific research contents are as follows.(1)Study on the definition of effectAnalysis of the effect indicators and trend of change:including the positive rate of hepatitis B surface antigen(HBsAg),the reported incidence of hepatitis B,the incidence of hepatitis B related diseases(including acute hepatitis B,chronic hepatitis B,hepatitis B cirrhosis,hepatitis B liver cancer,etc.).The relationship between the effect index and vaccination rate:vaccination rate and hepatitis B surface antigen positive rate belong to one to one relationship.Whether the increase of hepatitis B vaccination rate will reduce the positive rate of HBsAg?(2)Cost-effectiveness analysisAnalyze the changes in cost according to the collected data,and the cost of each year and the change of the cost of the year.The change of efficacy mainly refers to the positive rate of hepatitis B surface antigen,the reported incidence of hepatitis B,the incidence of hepatitis B cirrhosis and the incidence of hepatitis B liver cancer.This study mainly analyzes the relationship between the cost change value and the effect change value,and carries on the incremental cost effect analysis and the marginal effect analysis.Methods(1)Documentary studyIn the process of data collection,this research has consulted a large number of documents and obtained the literature data.The data on the incidence of liver cancer from 1992 to 2013 in Beijing were all from the literature,including statistical yearbook,annual work summary,published papers and so on.(2)Survey methodIn the early data collection process,this research uses the survey method to obtain the related data of the Centers for Disease Control and prevention in Beijing.(3)Missing value filling methodDuring the collection and sorting of the effect data,the missing data caused by long years and missing statistics were systematically filled in this study.The filling methods include proportional estimation,trend extrapolation,and moving average method.(4)Cost effectiveness analysisThe purpose of this study is to analyze the cost-effectiveness analysis of hepatitis B vaccine in Beijing,including cost effectiveness ratio,incremental cost-effectiveness ratio and marginal effect analysis.Results(1)From 1992 to 2013,the positive rate of HBsAg in Beijing was 6.33%,except for the previous year in 2007.All the other years showed a downward trend.The positive rate of HBsAg in 1992 was 5.76%,3.68%in 2006 and 2.4%in 2013.From 1992 to 2003,the incidence of hepatitis B,the incidence of chronic hepatitis B and the incidence of hepatitis B were all steadily decreasing.From 2003 to 2006,the incidence of hepatitis B and the incidence of chronic hepatitis B increased significantly.The incidence of chronic hepatitis B was fluctuated during this period,but the overall level increased significantly.From 2007 to 2013,both the incidence of hepatitis B and the incidence of chronic hepatitis B had a significant decline.(2)With the increase of the total cost of hepatitis B immunization,the total number of hepatitis B immune reduction is on the rise,and the trend of the increase is very obvious.Among them,the number of hepatitis B liver cancer(HCC)in the period of-2013 in 1992 has declined.(3)With the increase of hepatitis B vaccination rate,the positive rate of HBsAg is decreasing.Moreover,after 1998,vaccination rate is higher than 98%.This trend is still obvious.With the increase of vaccination rate,the positive rate of HBsAg is decreasing.(4)With the increase of the total cost of hepatitis B,the incidence of acute hepatitis B,the incidence of chronic hepatitis B,the incidence of hepatitis B cirrhosis and the incidence of hepatitis B liver cancer all showed a trend of first growth and then a downward trend.In terms of cost-effectiveness,the cost-effectiveness ratio showed an increasing trend in the total cost of hepatitis B immunization and the positive rate of HBsAg,the incidence of acute hepatitis B,the incidence of chronic hepatitis B,the incidence of hepatitis B cirrhosis and the incidence of HBV liver cancer.In the analysis of incremental cost effectiveness.The comparison between the three periods from 1992 to 1998,1999 to 2005 and 2006 to 2013,the incremental cost effect of the period from 1999 to 2005 is better.(5)In the incremental cost-effectiveness analysis of vaccine cost,manpower cost,hospital cost,CDC cost and community health service center cost as the cost index,compared with the three periods from 1992 to 1998,1999 to 2005 and 2006 to 2013,the incremental cost effectiveness of the period from 1999 to 2005 was better than the other two periods.ConclusionOverall,from the cost effectiveness of hepatitis B immunization program in Beijing from 1992 to 2013,the immunization program of hepatitis B vaccine has achieved satisfactory results.(1)With the increase of the total cost of immunization for hepatitis B,the incidence of acute hepatitis B,the incidence of chronic hepatitis B,hepatitis B liver cirrhosis and HBCC all increased and then decreased.(2)With the increase of hepatitis B vaccine inoculation rate,the positive rate of HBsAg showed a downward trend.There is a strong correlation between the hepatitis B vaccination and the positive rate of HBsAg.Vaccination is an ideal protective effect for preventing acute infection of hepatitis B.(3)As the total cost of hepatitis B immune input continues to rise,the total number of hepatitis B immune reduction is on the rise,and the correlation is more obvious.(4)In the analysis of the total cost of the hepatitis B immune input,the cost of different cost categories,and the cost effectiveness of different institutional categories,the incremental cost effectiveness of the period from 1999 to 2005 was better than the other two periods. |
PDF Full Text Request