健康发展与政策研究2024，Vol.27Issue(1)：21-28,8.DOI:10.12458/HDPR.230300
孕早期胎儿结构畸形超声筛查的卫生经济学评价
Health economics evaluation of first-trimester ultrasound screening for fetal structural abnormalities
摘要
Abstract
Objective To evaluate the cost-utility of ultrasound screening for fetal structural abnormalities in first-trimester compared to mid-trimester,providing evidence-based support for clinical optimization.Methods From a social perspective in China,a decision tree model was developed to simulate the clinical choices and pregnancy outcomes of two different prenatal screening programs for pregnant women who underwent ultrasound screening for fetal structural abnormalities in first-trimester(the intervention group)and those in mid-trimester(the control group),and to assess the cost-utility of the two groups with different pregnancy outcomes.The model simulation duration was 18 weeks,The clinical transition probabilities of pregnancy and cost were obtained from Shenzhen Nanshan Maternity&Child Healthcare Hospital,and the utility data from the published literature.Outcome measures included cost,quality adjusted life years(QALYs)and incremental cost-effectiveness ratio(ICER).The sensitivity analysis was conducted to examine the robustness of the model findings.Results Compared to the control group,the intervention group could reduce unnecessary pregnancies,achieving more QALYs with less total cost and an ICER of-¥161732.68/QALY,which presented an absolute cost-effectiveness advantage.Probabilistic sensitivity analysis indicated the robustness of the baseline analysis results.Again,the probability of the intervention group being cost-effective is 94.60%.Conclusion From the societal point of view,first-trimester ultrasound screening for fetal structural abnormalities possesses an unequivocal economic advantage compared to mid-trimester ultrasound screening.关键词
胎儿结构畸形/出生缺陷/超声筛查/孕早期/孕中期/成本-效用分析/决策树模型Key words
Fetal structural abnormalities/Birth defect/Ultrasound screening/First-trimester/Mid-trimester/Cost-utility analysis/Decision tree model分类
医药卫生引用本文复制引用
敖超群,蒋理添,夏珣,厉进,伍丽群..孕早期胎儿结构畸形超声筛查的卫生经济学评价[J].健康发展与政策研究,2024,27(1):21-28,8.基金项目
广东省医学科学技术研究基金项目(C2022120) （C2022120）
