Cc phng php phn tch

trong kinh t dc
TS. Nguyn Th Thu Thy

1. Cc phng php nghin cu kinh t dc

1. Phn tch gi thnh bnh (COI Cost of illness)
2. Phn tch ti thiu ha chi ph (CMA cost-minimization
analysis)
3. Phn tch chi ph-hiu qu (CEA - Cost-effectiveness
analysis)
4. Phn tch chi ph hiu lc (CUA - Cost-utility analysis)
5. Phng php chi ph li ch (CBA - Cost-benefit
analysis)

2. Phn tch gi thnh bnh

Phn tch ton b chi ph tin hnh chn on- iu tr
mt bnh c th
L nghin cu kinh t dc duy nht khng tnh n hiu
qu iu tr
c coi l nh gi bnh v mt kinh t v l c s phn
b ngun vn ca b y t gia cc bnh khc nhau
Cn thit tm ra nhng bnh l gnh nng v mt kinh t
cho ngi bnh v x hi
a ra nhng thng tin b ch v cu trc ca chi ph v
gip nh hng nghin cu nhng chi ph cao nht

2. Phn tch gi thnh bnh

Gi thnh bnh c tnh theo cng thc tnh:

COI = DC + IC
COI : cost of illness (gi thnh bnh)
DC: direct cost (chi ph trc tip)
IC: indirect cost (chi ph gin tip)
Trong trng hp bnh din ra theo nhiu giai on iu tr khc
nhau (ni tr, ngoi tr, cp cu...), gi thnh bnh s c tnh
theo cng thc sau:

COI = (DC1 + IC1) + (DC2+IC2) + (DC3+ IC3)+...

Trong : 1, 2, 3... giai on bnh 1, 2, 3, ...

3. Phn tch ti thiu ha chi ph

Phng php kinh t dc c s dng tm ra chnh
lch chi ph gia 2 can thip y t (thng l thuc) c ch s
hiu qu ngang nhau.
V d: phn tch ti thiu ha chi ph gia cc thuc generic.

Thuc A

Thuc B

3. Phn tch ti thiu ha chi ph

CMA = (DC2 + IC2) (DC1 + IC1)
CMA: ti thiu ha chi ph
DC1, DC2: Chi ph iu tr trc tip bng liu php 1, 2
DC1, DC2: Chi ph iu tr gin tip bng liu php 1, 2
Chi ph gin tip

Chi ph ngoi y t trc tip

Chi ph y t trc tip

4. Phn tch chi ph-hiu qu

Phng php kinh t dc so snh gia 2 liu php iu tr
khc nhau v chi ph v hiu qu
Phng php ny cho php xc nh liu php iu tr no
hiu qu hn v mt kinh t da trn chnh lch gia hiu
qu v chi ph

X
Thuc A

Thuc B

4. Phn tch chi ph-hiu qu

Ni tri hn

Ni tri hn

Chi ph
Hiu qu

Ni tri hn

Tng ng nhau

Trng hp 1, cn phi tin hnh phn tch ch s gia tng

(tnh ch s ICER)

4. Phn tch chi ph-hiu qu

Ch s
hiu qu

(DC + IC)

CER =
Ef
CER: ch s chi ph-hiu qu (cost-effectiveness ratio)
DC: Chi ph trc tip ca liu php iu tr
IC: Chi ph gin tip ca liu php iu tr
Ef: Ch s hiu qu ca liu php iu tr
Chi ph ngoi y t trc tip
Chi ph y t trc tip

So snh ch s CER gia 2 liu php iu tr, CER ca liu php no thp
hn th liu php c hiu qu kinh t hn

4. Phn tch chi ph-hiu qu

Cng thc tnh

ICER (Incremental CER)

ICER: Incremental Cost-Effectiveness ratio (Ch s gia tng chi ph-hiu qu)
DC1, DC2: Chi ph trc tip liu php iu tr 1, 2
IC1, IC2: Chi ph gin tip liu php iu tr 1, 2
Ef1, Ef2: Ch s hiu qu ca liu php iu tr 1, 2

5. Phn tch chi ph hiu lc

L 1 dng ca phng php phn tch chi ph-hiu qu
trong ch s hiu qu l ch s sc khe.
Ch s sc khe thng c dng l QALY (qualityadjusted life-year gained: nm sng c cht lng iu
chnh)

6. Phn tch chi ph li ch

L phng php phn tch kinh t dc trong c chi ph
v li ch u c tnh bng n v tin
y l phng php cho php tnh li ch kinh t ca liu
php ny so vi liu php kia trong iu tr nhng bnh c
th
L phng php t dng v nhng kh khn nht nh trong
vic tnh ch s hiu qu bng n v tin t.

7. Nguyn tc 3
Khi tin hnh nghin cu kinh t dc khoa cn tun
th quy tc 3
ng ch s hiu qu
ng ch s chi ph
ng thit k nghin cu