目的 利用伤残调整健康生命年( disability adjusted lifeyear,DALY)指标分析江西省结核病防治经费投入和产出,计算成本效益比,为政府合理分配有限的卫生经费、制订结核病防治策略提供依据。方法 根据《全国结核病防治规划( 2011~2015 年) 中期评估方案》和实施细则,设区市和县级逐级上报、省级审核汇总。选用DALY 指标量化,计算成本效益比。结果 江西省2011～2015年共投入结核病防治经费31 581.16万元,减少的医疗费用为5 351.22万元,挽回的社会总价值为2 361 493.13万元,产生的总效益为2 366 844.35万元,挽回的总DALY值为1 099 273.5,每挽回1个DALY平均需要投入金额为287.29元,成本效益比为74.94,即每投入1元可产生74.94元的社会经济效益。结论 5年间江西省结核病防治成本效益显著。但全省仍需加强各级财政投入特别是市和县两级财政投入,通过多种形式宣传提高公众结核病防治知识知晓率,继续执行现有的结核病防控策略。

Objective To analyze funding inputs and outputs of Jiangxi province for tuberculosis(TB) control by DALY indicator to calculate the benefit cost ratio, and provide references for the government rational allocation of limited health funding and formulating tuberculosis control strategy. Methods The mid-term evaluation embodiment of The National TB Control Programme ( 2011－2015) was used as basis. The cities and counties ( cities, districts) reported the data and we audited summary, choose DALY quantitative indicators, and calculated the benefit- cost ratio. Results From 2011 to 2015, in Jiangxi province we invested a total of TB control funds 315.8116 million yuan, reduced the medical expenses of 53.5122 million yuan, saved social total value of 23 billion and 614.9313 million yuan. The total profit was 23 billion and 668.4435 million yuan, and the total DALY redemption value was 1099273.5.Each 1 DALY needed the average investment amount of 287.29 yuan, and the benefit cost ratio was 74.94.It meant that each invested 1 yuan could produce 74.94 yuan of social and economic benefits. Conclusions In 5 years, the benefit-cost ratio of TB control in Jiangxi province was large. But our province still needs to strengthen financial investments of all levels,mespecially at city and county levels.We need to improve public awareness of tuberculosis prevention knowledge through a variety of forms of publicity,and continue to implementate the existing strategy of TB prevention and control. We will push forward the prevention and control work of TB through above all these measures.