Cost-effectiveness of school support for orphan girls to prevent HIV infection in Zimbabwe.
Cost-effectiveness of school support for orphan girls to prevent HIV infection in Zimbabwe.
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DOI：
10.1007/s11121-012-0315-0
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发表时间：
2013-10
影响因子：
3.5
通讯作者：
Waehrer, Geetha
中科院分区：
文献类型：
--
作者：
Miller, Ted;Hallfors, Denise;Cho, Hyunsan;Luseno, Winnie;Waehrer, Geetha
这项成本效益研究分析了在一项随机对照试验中获得的每质量调整生命年（QALY）的成本，该试验将学校支持作为一种结构性干预措施，以预防津巴布韦孤儿少女中的艾滋病毒风险因素。干预措施大大减少了早婚，增加了完成学业的年数，并提高了与健康有关的生活质量。通过减少早婚，文献表明干预措施减少了艾滋病毒感染。这项干预措施产生了大约1472美元的社会效益，每个孤儿获得大约0.36夸脱的支持。据估计，它的成本为6美元/QALY，约占津巴布韦年人均收入的1%。这远远低于世界卫生组织（世卫组织）宏观经济学和卫生委员会建议为中低收入国家的健康收益支付的最高价格。在干预条件下，大约有一半的女孩在上高中时被寄宿。对于非寄宿生来说，干预措施的经济效益超过了成本，估计每个学生节省的净成本为502美元。如果没有寄宿，干预措施将产生净节省，即使它在复制中的效率降低了34%。寄宿不符合成本效益。每名寄宿女孩额外花费1,234美元（在研究的三年中，以3%的折扣率贴现至现值），但对治疗组中未寄宿女孩的任何结局指标没有影响。对于没有寄宿的女孩，大约三年的学校支助平均费用为973美元。
This cost-effectiveness study analyzes the cost per quality-adjusted life year (QALY) gained in a randomized controlled trial that tested school support as a structural intervention to prevent HIV risk factors among Zimbabwe orphan girl adolescents. The intervention significantly reduced early marriage, increased years of schooling completed, and increased health-related quality of life. By reducing early marriage, the literature suggests the intervention reduced HIV infection. The intervention yielded an estimated US$1, 472 in societal benefits and an estimated gain of 0.36 QALYs per orphan supported. It cost an estimated US$6/QALY gained, about 1% of annual per capita income in Zimbabwe. That is well below the maximum price that the World Health Organization (WHO) Commission on Macroeconomics and Health recommends paying for health gains in low and middle income countries. About half the girls in the intervention condition were boarded when they reached high school. For non-boarders, the intervention’s financial benefits exceeded its costs, yielding an estimated net cost savings of $502 per pupil. Without boarding, the intervention would yield net savings even if it were 34% less effective in replication. Boarding was not cost-effective. It cost an additional $1,234 per girl boarded (over the three years of the study, discounted to present value at a 3% discount rate) but had no effect on any of the outcome measures relative to girls in the treatment group who did not board. For girls who did not board, the average cost of approximately three years of school support was US$973.
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DOI：
10.1097/ta.0b013e31802b71c9
发表时间：
2007-01-01
影响因子：
--
作者：
Polinder, Suzanne;van Beeck, Ed F.;Meerding, Willem Jan
通讯作者：
Meerding, Willem Jan
影响因子：
120.7
作者：
Resnick, MD;Bearman, PS;Udry, JR
通讯作者：
Udry, JR
影响因子：
7.6
作者：
Cho, Hyunsan;Hallfors, Denise D.;Iritani, Bonita J.
通讯作者：
Iritani, Bonita J.
影响因子：
3.3
作者：
Cowan, Frances M.;Pascoe, Sophie J. S.;Hayes, Richard J.
通讯作者：
Hayes, Richard J.
DOI：
10.1016/0738-0593(93)90035-x
发表时间：
1993-07-01
影响因子：
2.5
作者：
BENNELL, P;MALABA, J
通讯作者：
MALABA, J