Cost Effectiveness Analysis of Health Examination for the Elderly--Example of Hypertension Screening

• Main Authors: Dang, Bing-Hwa, 鄧丙華
• Other Authors: Chiu Herng-Chia
• Format: Others
• Language: zh-TW
• Published: 1998
• Online Access: http://ndltd.ncl.edu.tw/handle/01190587408904637608

碩士 === 高雄醫學院 === 公共衛生學研究所 === 86 === The major purposes of this study are to understand the prevalence and incidence rates of hypertension of the elderly who attended health examination program in Kaohsiung city; furthermore, Cost-Effectiveness Analysis(CEA) was used to evaluate the cost and effectiveness of hypertension screening as with the example of stoke patients.Elderly who attended 1995 and 1996 Health Examination Program, sponsored by Kaohsiung City government and Bureau of National Health Insurance, were included in the study.Five hypothetical models for each prevalence and incidence were developed to evaluate the cost effectiveness in different conditions.Sensitivity analysis was used to evaluate effect of each estimation indicators on the cost effectiveness.The results indicated that prevalence rate of hypertension was 24.6%, and incidence rate was 6.6%.Conservative estimation as shown in Model1, both of prevalence and incidence inferential models indicated that, each hypertension patient who had attended health examination not only save NT$ 8,759~8,439, but also increased the life of 45 days.In model5, ideal estimation, each hypertension patient who had attended health examination not only save NT$34,890~34,570, but also increased the life of 128 days.According to the results of sensitivity analysis, cost effectiveness was sensitive to following estimation indicators:stroke rate in treated patients, stroke rate in untreated elderly, annual costs of hypertension treatment, proportions of stroke patients in home care, monthly average direct cost of nursing home, and to compliance of medication.The implications of the results can be useful for health and social welfare policy relate to the elderly.This study suggests more promotion for the health examination program of the elderly are critical to maximize its cost effectiveness. Schedule education programs, before and after health examination, are also essential for hypertension patients who should seek for treatment and keep compliant for a lower incidence rate of stroke.