2型糖尿病三种并发症筛查的成本研究

叶迎风; 张馨予; 窦冠珅; 应晓华; 蔡淳

doi:10.19428/j.cnki.sjpm.2018.18893

2型糖尿病三种并发症筛查的成本研究

Screening costs of three complications for type 2 diabetes mellitus

摘要

摘要:
目的测算2型糖尿病三种并发症筛查的成本，包括糖尿病肾病、周围神经病变和下肢动脉病变，并分析成本构成。
方法基于2015—2017年“上海市代谢性疾病(糖尿病)预防和诊治服务体系建设”项目，调查了上海市16个区县的社区糖尿病并发症筛查的各项投入，并采用微观成本法计算糖尿病并发症筛查成本。
结果到2017年8月，已经筛查了203 040个糖尿病患者，共计花费3 890.28万元，三种慢性并发症的次均总筛查成本约为191.60元，其中糖尿病肾病的次均筛查成本约为170.90元，周围神经病变与下肢动脉病变次均筛查成本约为13.59元和7.11元；三种慢性并发症的人均总筛查成本约为16.54元，糖尿病肾病的人均筛查成本约为14.75元；实验室检查是筛查中最主要的成本支出，其次是人力支出。
结论糖尿病并发症筛查的成本不高，有潜在的推广价值；实验室检查是决定筛查成本高低的关键因素。

Abstract:
ObjectiveTo calculate the cost of screening for three complications of type 2 diabetes, including diabetic nephropathy, peripheral neuropathy, and lower extremity arterial disease, and to analyze its composition of the cost.
MethodsThis study is one of parts of "Shanghai Metabolic Disease (Diabetes) Prevention and Diagnosis Service System Construction Project 2015-2017".The costs in diabetes complication screening in all districts and communities in Shanghai were investigated.Micro-cost method was used to calculate the costs of diabetes complications screening.
ResultsBy August 2017, total 203 040 patients with diabetes had been screened.It costed around 38.9 million RMB on these screening together.The average cost of screening for the three chronic complications was approximately 191.60 RMB, including cost of 170.90 RMB for diabetic nephropathy screening.The cost per capita of the three chronic complications is approximately 16.54 RMB, and the per capita screening cost of diabetic nephropathy is approximately 14.75 RMB.Laboratory examining expenditure accounted for main cost for screening, followed by manpower expenditure.
ConclusionDiabetic complication screening is not costly and has potential promotion value.Laboratory inspection cost is the main determinant composition for the cost.

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