Conceptualising the technical relationship of animal disease surveillance to intervention and mitigation as a basis for economic analysis
Conceptualising the technical relationship of animal disease surveillance to intervention and mitigation as a basis for economic analysis
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DOI：
10.1186/1472-6963-11-225
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发表时间：
2011-09-19
影响因子：
2.8
通讯作者：
Staerk, Katharina D. C.
中科院分区：
文献类型：
--
作者：
Haesler, Barbara;Howe, Keith S.;Staerk, Katharina D. C.
背景：监测和干预是资源使用活动的战略，以减轻疾病的不良影响。资源是稀缺的，将其用于减轻疾病而不是其他用途必然会使人们失去其他利益来源。为了使社会从资源利用中获得最大利益，必须将疾病缓解的收益与资源成本进行比较，以实现最佳净outcome.Discussion的目标指导决策：经济学提供了指导决策的标准，旨在优化稀缺资源利用的净收益。评估减轻疾病的益处也不例外。然而，缓解的技术复杂性意味着，由于监测与干预的技术关系，经济评估并不简单。我们认为，分析的幅度和分配的利益和成本为任何给定的战略，因此，结果在净值方面，需要缓解被认为是在三个概念上不同的阶段。在第一阶段，“维持”，缓解目标是通过防止病原体增加或在病原体出现时消除病原体，维持一种自由或可接受的状态。监测的作用是记录病原体保持在规定阈值以下，对发病率增加或其他重大风险变化发出预警，并使早期反应成为可能。如果病原体没有被控制，情况需要被评估为第二阶段，“调查”。在此，监测获得关键的流行病学信息，以决定适当的干预战略，以减少或消除第三阶段“实施”中的疾病。第三阶段监测告知的选择，时间和规模的干预措施和文件的进展，针对在患病率降低population.Summary：本文源于一个研究项目，开发一个概念框架和实用工具的经济评估监测。探索作为经济价值来源的缓解与作为经济成本来源的监测和干预之间的技术关系至关重要。提出了一个连接关键技术关系的框架。确定了三个概念上不同的缓解阶段。禽流感，沙门氏菌，口蹄疫提出来说明框架。
Background: Surveillance and intervention are resource-using activities of strategies to mitigate the unwanted effects of disease. Resources are scarce, and allocating them to disease mitigation instead of other uses necessarily involves the loss of alternative sources of benefit to people. For society to obtain the maximum benefits from using resources, the gains from disease mitigation must be compared to the resource costs, guiding decisions made with the objective of achieving the optimal net outcome.Discussion: Economics provides criteria to guide decisions aimed at optimising the net benefits from the use of scarce resources. Assessing the benefits of disease mitigation is no exception. However, the technical complexity of mitigation means that economic evaluation is not straightforward because of the technical relationship of surveillance to intervention. We argue that analysis of the magnitudes and distribution of benefits and costs for any given strategy, and hence the outcome in net terms, requires that mitigation is considered in three conceptually distinct stages. In Stage I, 'sustainment', the mitigation objective is to sustain a free or acceptable status by preventing an increase of a pathogen or eliminating it when it occurs. The role of surveillance is to document that the pathogen remains below a defined threshold, giving early warning of an increase in incidence or other significant changes in risk, and enabling early response. If a pathogen is not contained, the situation needs to be assessed as Stage II, 'investigation'. Here, surveillance obtains critical epidemiological information to decide on the appropriate intervention strategy to reduce or eradicate a disease in Stage III, 'implementation'. Stage III surveillance informs the choice, timing, and scale of interventions and documents the progress of interventions directed at prevalence reduction in the population.Summary: This article originates from a research project to develop a conceptual framework and practical tool for the economic evaluation of surveillance. Exploring the technical relationship between mitigation as a source of economic value and surveillance and intervention as sources of economic cost is crucial. A framework linking the key technical relationships is proposed. Three conceptually distinct stages of mitigation are identified. Avian influenza, salmonella, and foot and mouth disease are presented to illustrate the framework.