Mitigating the heroin crisis in Baltimore, MD, USA: a cost-benefit analysis of a hypothetical supervised injection facility
Mitigating the heroin crisis in Baltimore, MD, USA: a cost-benefit analysis of a hypothetical supervised injection facility
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DOI：
10.1186/s12954-017-0153-2
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发表时间：
2017-05-12
影响因子：
4.4
通讯作者：
Sherman, Susan G.
中科院分区：
文献类型：
--
作者：
Irwin, Amos;Jozaghi, Ehsan;Sherman, Susan G.
背景：在马里兰州巴尔的摩，与美国许多城市一样，由于处方阿片类药物滥用以及药品市场上芬太尼和其他合成阿片类药物滥用的增加，用药过量率正在上升。监督注射设施 (SIF) 是一种在全世界广泛实施的公共卫生干预措施，全球 11 个国家设有 97 个。研究已经记录了 SIF 的公共健康、社会和经济效益，但在美国尚不存在。本研究的目的是对巴尔的摩假设的 SIF 的健康和财务成本及效益进行建模。方法：我们利用当地健康数据和现有 SIF 在六种结果模型中的影响数据来估计效益：防止人类免疫缺陷病毒传播、丙型肝炎病毒传播、皮肤和软组织感染、用药过量死亡率、与用药过量相关的医疗护理以及增加对阿片类药物依赖的药物辅助治疗。结果：我们预测每年的成本为 $ 180 万人，单个 SIF 可以节省 780 万美元，预防 3.7 例艾滋病毒感染、21 例丙型肝炎感染、因皮肤和软组织感染住院 374 天、5.9 例药物过量死亡、108 起与药物过量相关的救护车呼叫、78 例急诊室就诊和 27 例住院治疗，同时又可以让 121 人接受治疗。具有成本效益，可为巴尔的摩市带来重大的公共卫生和经济效益。
Background: In Baltimore, MD, as in many cities throughout the USA, overdose rates are on the rise due to both the increase of prescription opioid abuse and that of fentanyl and other synthetic opioids in the drug market. Supervised injection facilities (SIFs) are a widely implemented public health intervention throughout the world, with 97 existing in 11 countries worldwide. Research has documented the public health, social, and economic benefits of SIFs, yet none exist in the USA. The purpose of this study is to model the health and financial costs and benefits of a hypothetical SIF in Baltimore.Methods: We estimate the benefits by utilizing local health data and data on the impact of existing SIFs in models for six outcomes: prevented human immunodeficiency virus transmission, Hepatitis C virus transmission, skin and soft-tissue infection, overdose mortality, and overdose-related medical care and increased medication-assisted treatment for opioid dependence.Results: We predict that for an annual cost of $ 1.8 million, a single SIF would generate $ 7.8 million in savings, preventing 3.7 HIV infections, 21 Hepatitis C infections, 374 days in the hospital for skin and soft-tissue infection, 5.9 overdose deaths, 108 overdose-related ambulance calls, 78 emergency room visits, and 27 hospitalizations, while bringing 121 additional people into treatment.Conclusions: We conclude that a SIF would be both extremely cost-effective and a significant public health and economic benefit to Baltimore City.