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Health–economics evaluation of community screening of PACG in China |
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作者:Liang Yu… 文章来源:Beijing Tongren Eye Center(北京同仁眼科中心), Beijing Tongren Hospital, Beijing, China, 点击数1706 更新时间:2005/6/15 11:13:50 文章录入:ybliang 责任编辑:毛进 |
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Purpose:Primary angle closure glaucoma has been thought a big problem in China, as estimated by Dr Paul J Foster, more than 9,100,000 populations expected to have primary angle closure, and 2,800,000 populations were exposed to occludable angle. However , the incidence rate of PACG was not very high, this study was to analyze the cost-effectiveness of PACG screening based on a previous longitudinal community-based study.
Methods :Using number of need to treat (NNT) to re-analyze the results of six-year follow-up of PACG suspects in Guangzhou conducted by Tiancai Ye et al and several cross-sectional clinical and population based studies . Cost-effectiveness and cost-utilize were analyzed.
Results: the mean onset age of PACG was 57~58 y/o, the mean onset age of blindness was estimated to be 62 y/o, the mean expected life of Chinese has been reported to be 72y/o. And in Ye et al’ study, the incidence rate of PACG was 30.5/10,000 during a six-year period in population aged ≥40 yrs. To reduce a case of PACG, nearly 327 people who aged ≥40 yrs would be screened, and 24 suspects should undergo laser iridotomy, the total cost would be ¥8,940 in China. To reduce one case of PACG resulting blindness, the cost would be at least ten times higher, the total cost would be ¥89,400 ,and 24 quality adjusted life years (QALYs) could be saved, then the cost/utilize value was about 3725¥/QALY.
In conclusion, although PACG is a big health problem in China, it wasn’t a cost-effective way to do community-based screening extensively. Combined strategies with other preventable blindness diseases and a reasonable interval for screening should be considered .
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