健康发展与政策研究2026，Vol.29Issue(3)：413-423,11.DOI:10.12458/HDPR.202502002
血清25-羟基维生素D用于中国65岁及以上人群骨折风险筛查的成本效用分析
Cost-utility analysis of serum 25-hydroxyvitamin D for screening fracture risk in Chinese population aged 65 and above
刘玉萍 1帅平 1刘佑韧 1左晨钰 2吴柏纬 2宣建伟2
作者信息
- 1. 四川省医学科学院·四川省人民医院(电子科技大学附属医院)健康管理中心,四川 成都 610000
- 2. 中山大学药学院,广东 广州 510000
- 折叠
摘要
Abstract
Objective This study aims to evaluate the health benefits and economic value of serum 25(OH)D screening among adults aged 65 and above in China.Methods A decision tree and a Markov model were developed to simulate the health benefits and costs of the"screening"strategy(screening group)versus the"non-screening"strategy(non-screening group)in the Chinese population aged 65 years and older.In both strategies,supplementation of vitamin D and calcium was based on individual willingness,except for vitamin D-sufficient individuals identified in the screening group,who did not supplement.Key baseline,clinical,cost,and utility parameters were derived from published literature,public databases,and expert interviews.One-way and probabilistic sensitivity analyses were conducted to assess parameter uncertainty.3 scenario analyses performed,targeting perimenopausal women,a region with a severely aged population(Sichuan Province),and varying levels of supplementation willingness.Results In the non-screening group,the willingness to supplement vitamin D and calcium among 25(OH)D-deficient individuals was 25.00%;in the screening group,the willingness rose to 65.00%among the same deficient population.Compared with the non-screening group,the screening group gained 0.014 incremental QALYs per person and saved 197.12 CNY in total lifetime costs per person.One-way sensitivity analysis showed that the incremental cost-utility ratio(ICUR)consistently remained below the willingness-to-pay threshold(95 749 CNY/QALY)regardless of parameter variation.Probabilistic sensitivity analysis showed that the screening strategy was dominant in 88.32%of simulations.Across all three scenarios—high-risk perimenopausal women(≥50 years),a region with a severely aged population(Sichuan Province),and varying assumptions regarding patient willingness to supplement—the screening strategy consistently demonstrated either cost savings(dominance)or a favorable cost-utility profile.Conclusion 25(OH)D screening in adults aged 65 and above can reduce fracture risk,improve health outcomes,and alleviate economic burden,representing a dominant strategy.关键词
25(OH)D筛查/维生素D/老年人群/成本效用/骨折Key words
25(OH)D screening/Vitamin D/elderly population/cost-utility analysis/fracture分类
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刘玉萍,帅平,刘佑韧,左晨钰,吴柏纬,宣建伟..血清25-羟基维生素D用于中国65岁及以上人群骨折风险筛查的成本效用分析[J].健康发展与政策研究,2026,29(3):413-423,11.
