Universal Lead Screening Requirement: A California Case Study
Universal Lead Screening Requirement: A California Case Study
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通用铅筛查要求：加州案例研究
DOI：
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发表时间：
2018
影响因子：
12.7
通讯作者：
R. Shimkhada
中科院分区：
文献类型：
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作者：
Sara B. McMenamin;Sarah P. Hiller;Erin Shigekawa;T. Melander;R. Shimkhada
目标 评估加州议会法案 (AB) 1316 的潜在影响：对儿童血铅检测进行全民筛查和保险覆盖的要求。方法 2017 年 4 月，加州健康福利审查计划（加利福尼亚州奥克兰）为加州立法机构分析了 AB 1316，包括对铅筛查有效性的系统审查、有关筛查覆盖范围的商业保险公司调查以及精算利用率和成本影响评估。结果 普遍筛查要求将使儿童铅检测量增加 273%，受影响人群的保费增加 0.0043%，并在实施一年后额外检测出 4777 名接触铅的儿童。结论 普遍筛查方法的净社会效益的证据有限，并且没有得到知名医学专业团体的支持。公共卫生影响 加州扩大了有针对性的筛查，以根据加州特有的风险因素识别更多铅中毒风险较高的儿童，同时减轻全民筛查的潜在危害，例如假阳性检测增加和医疗保健费用增加。
Objectives To estimate potential impacts of California Assembly Bill (AB) 1316: a requirement for universal screening and insurance coverage for child blood lead testing. Methods In April 2017 the California Health Benefits Review Program (Oakland, CA) analyzed AB 1316 for the California legislature, including a systematic review of lead screening effectiveness, commercial insurer surveys regarding screening coverage, and actuarial utilization and cost implication assessments. Results Universal screening requirements would increase child lead testing by 273%, raise affected populations’ premiums by 0.0043%, and detect an additional 4777 exposed children 1 year after implementation. Conclusions The evidence for a net societal benefit of universal screening approach is limited and is not supported by prominent medical professional groups. Public Health Implications California expanded targeted screening to identify additional children at higher risk for lead poisoning on the basis of California-specific risk factors, while mitigating the potential harms of universal screening such as an increase in false positive tests and health care costs.