Cost-effectiveness of mass screening for dipstick hematuria in Japan
Cost-effectiveness of mass screening for dipstick hematuria in Japan
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DOI：
10.1007/s10157-021-02170-0
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发表时间：
2022-01-08
影响因子：
2.3
通讯作者：
Iseki, Kunitoshi
中科院分区：
文献类型：
--
作者：
Okubo, Reiko;Hoshi, Shu-Ling;Iseki, Kunitoshi
尿试纸检测是检测肾脏和泌尿系统疾病（如IgA肾病和膀胱癌）的一种简单而廉价的方法。这项全国性的大规模筛查项目，即特殊健康检查（SHC），于2008年在日本启动，目标是所有40至74岁的成年人。蛋白尿和血糖的试纸尿检是SHC的一部分，但血尿的试纸尿检不是强制性的。然而，一些健康保险公司经常将试纸血尿测试与这些强制性测试同时进行。血尿在日本普通筛查参与者中很常见，特别是老年妇女，并且讨论了使用试纸血尿试验进行大规模筛查的必要性。本研究旨在评估除SHC外，大规模筛查试纸血尿试验的成本效益。方法采用决策树模型和马尔可夫模型，从日本社会视角进行成本效益分析。结果与目前的SHC相比，除SHC外，大规模筛查试纸血尿试验成本更低，收益更高，节约了成本。在性别分析中也观察到类似的结果。结论强制性试纸血尿试验是对有限医疗资源的有效利用。研究结果不仅对日本乃至全世界的大规模筛查项目都有启示意义。
Background Dipstick urine tests are a simple and inexpensive method for detecting kidney and urological diseases, such as IgA nephropathy and bladder cancer. The nationwide mass screening program, Specific Health Checkup (SHC), started in Japan in 2008 and targeted all adults between 40 and 74 years of age. Dipstick urine tests for proteinuria and glucosuria are mandatory as part of the SHC, but dipstick urine tests for hematuria are not. However, the dipstick hematuria test is often administered simultaneously with these mandatory tests by some health insurers. Hematuria is common in Japanese general screening participants, particularly elderly women, and the necessity of mass screening using the dipstick hematuria test has been discussed. This study aimed to evaluate the cost-effectiveness of mass screening for dipstick hematuria tests in addition to the SHC. Methods Using a decision tree and Markov modeling, we conducted a cost-effectiveness analysis from a Japanese societal perspective. Results Compared with the current SHC, mass screening for dipstick hematuria tests, in addition to the SHC, costs less and gains more, which means cost-saving. Similar findings were observed in the sex-specific analysis. Conclusion Our results suggest that mandating the dipstick hematuria test could be justifiable as an efficient use of finite healthcare resources. The results have implications for mass screening programs not only in Japan but worldwide.