| ObjectiveTo explore the health economic evaluation of China tumor information-related surveillance systems(chronic disease and nutrition surveillance,death surveillance,cancer registry),that is,to conduct analysis of content output and cost input.To outline the strengths and weaknesses,and to provide suggestions for the future development and construction of China tumor information-related surveillance systems.Methods1.To structure the content output evaluation index system for evaluation of the information integrity of each surveillance system.Initially,according to the complete information content which should be contained in tumor information-related surveillance system ideally,form indexes of two levels and specific content items that each secondary-level index includes by literature analysis and expert demonstration.Then,by analytic hierarchy process(AHP),determine the weights of all indexes and construct the evaluation index system finally.2.Carry out investigation and interview in relevant institutions at different levels.collecting data:(1)according to the content output evaluation index system established,investigate the degree to which each item of secondary index can be included by information of each surveillance system.(2)from national perspective(program manager perspective),investigate the country’s input of cost on each system and classify it into fixed cost(system maintenance and construction cost,other cost of the national team)and variable cost.3.On the basis of investigation.the evaluation index system was applied to calculate indexes scores and total scores respectively(full score is 1)of each surveillance system and their integration.Using Interest rates(i)of 0.00.0.03,0.05,and 0.08 to adjust the time value of money to 2017,calculate national input of cost:fixed cost,variable cost,total cost,and average fixed cost,average variable cost,average total cost of one case on each surveillance system.Calculate the summary of average total cost of 3 systems.4.The ratio of the average total cost to the total score of indexes system(0.01 unit score is converted into 1 unit score,full score is 100)is calculated,that is,the cost-score ratio.ResultsThe evaluation system includes 3 types of 1st level indexes with weights,and 9 types of 2nd level indexes.with ordering weights in single level and whole system."Risk factors"(0.406)includes"personal factors"(single 0.177,whole 0.072),"environmental factors"(single 0.227,whole 0.092),"behavioral pattern"(single 0.344,whole 0.139)and"hereditary factors"(single 0.252,whole 0.102)."Early detection and screening"(0.359)includes"early symptoms"(single 0.317,whole 0.114)and"detection information"(singe 0.683,whole 0.245)."Diagnosis,treatment and prognosis"(0.236)includes "diagnosis"(single 0.480,whole 0.113),"treatment"(single 0.274,whole 0.065)and"prognosis"(single 0.246,whole 0.058).For chronic disease and nutrition surveillance,death surveillance,cancer registry and their integration,total score of evaluation indexes systems:30.04,11.46,27.81,53.32.For chronic disease and nutrition surveillance,death surveillance and cancer registry,variable cost:21946.77,3147.00,3897.00(wan yuan);fixed cost:291.25,162.79,1086.05(wan yuan);total cost:22238.02,3309.79,4983.05(wan yuan);average variable cost:1211.19,15.81,29.83(yuan);average fixed cost:16.07.0.82,8.31(yuan);average total cost:1227.26,16.63,38.15(yuan);summary of average total cost:1282.04(yuan).(i=0.03,the results are stable with other different value of i).For chronic disease and nutrition surveillance,death surveillance,cancer registry and their integration,cost-score ratio:40.85.1.45,1.37,24.04.ConclusionNow,no system can excel in both content output and cost input.In terms of economy of content output and cost input(cost-score ratio),death surveillance and cancer registry are far superior to chronic disease and nutrition surveillance.In terms of content output,chronic diseases and nutrition surveillance performs better than tumor registry and death surveillance while none of them is satisfying.Meantime,the significance of information on risk factors,early signs and screening stands out.In terms of cost input.chronic disease and nutrition surveillance is much higher than cancer registry and death surveillance,and their cost structure differs greatly.It is necessary to continue the construction and development of tumor information related surveillance system in China to meet the information needs of tumor prevention and control,especially increasing the content integrity and economy. |
