| According to the latest research report of the World Health Organization,the number of myopia patients in China is as high as 600 million.The myopia rate of primary school students is also close to 40%.The youth myopia rate in China is the highest in the world.And this data is still climbing year by year.The increasing number of patients with poor vision will cause serious economic losses to the socioeconomic development and patients with poor vision.And poor eyesight can adversely affect the academic performance,physical and mental health of school-age children.In the new stage of China's economic development,the poor eyesight of young children will indirectly affect the accumulation of human capital in China.Then,to solve the problem of poor eyesight,we must first discover this problem.Vision screening is the most crucial first step to discover the vision problems of young children.Children can be diagnosed with vision problems as soon as possible after visual screening.On August 30,2018,the Ministry of Education and the National Health and other eight departments jointly issued the "Implementation Plan for the Prevention and Control of Myopia for Children and Adolescents",The plan indicates that vision screening and monitoring is important.Under the background of national policy and reality,this study aims to explore an effective scheme of visual screening for students.The data in this paper are the visual acuity screening of 1441 1 students from 252 schools in two provinces in Northwest China.The screening was conducted by teachers or volunteers.Then the optometrists from Zhongshan Ophthalmological Center randomly selected 754 students who were screened by teachers and 397 students who were screened by volunteers for the second quality screening to judge the accuracy of two kinds of screening.This study compares the cost-effectiveness of the two vision screening programs.It aims to explore the most cost-effective visual screening program for students,and to optimize the allocation of limited resources,to provide the basis for decision-makers and thus promote the accumulation of human capital in China.In order to achieve the above objectives,this study firstly analyzes the current situation of visual screening and poor vision of students in rural areas of western China;then uses sensitivity,specificity,correct value,area AUC value under ROC curve and Kappa index to evaluate the screening quality of the two students' vision screening programs.Finally,the paper analyzed and discussed the cost-effectiveness of teacher screening and volunteer screening using incremental cost effectiveness.The main conclusions of this study are as follows:Only one-third of the schools that organize eyesight screening in rural areas in northwest China each year,only 15.53%of students have undergone visual inspection under the leadership of parents.The chances of obtaining visual screening at the family level are low in the process of their growth.In this environment,the accuracy of teacher screening in this paper was 81.6%,and the volunteer screening was 83.1%.Both vision screening programs had higher screening quality,but the screening quality of volunteers was 1.5%higher than that of teachers.The cost-effectiveness ratio(CER)of teacher screening and volunteer screening for unit cost measurement is 4.34,9.35,respectively,indicating that 1%accuracy increases in every student's screening quality,teacher screening requires an additional fee of 4.34 yuan,while volunteers screening requires 9.35 yuan.Teacher screening is more cost-effectiveness student vision screening program than volunteer screening.Based on the above research conclusions,first,this paper suggests that regular visual screening should be carried out for adolescents.Second,teacher screening is the most cost-effective in the selection of visual screening personnel.It 1s recommended that vision screening be included in the teacher's responsibilities.Adolescents can enjoy the benefits of regular vision screening at the lowest total social cost. |
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