Cost-effectiveness and mortality risk impact on elderly health management of essential public health services:A case study in Henan Province
10.3969/j.issn.1674-2982.2025.11.003
- VernacularTitle:基本公共卫生服务项目老年人健康管理服务的成本效益及死亡风险影响研究
- Author:
Zhi-ping GUO
1
;
Rong-mei LIU
;
Neng-guang DAI
;
Yi LI
;
Tong JIN
;
Qiu-ping ZHAO
;
Hao SHI
;
Chun-rong BAO
;
Yan-qing MIAO
Author Information
1. 阜外华中心血管病医院 郑州大学华中阜外医院 河南 郑州 451400
- Publication Type:Journal Article
- Keywords:
National essential public health services;
Health management for the elderly;
Cost-effectiveness;
Risk of death
- From:
Chinese Journal of Health Policy
2025;18(11):17-24
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the cost-effectiveness and impact on mortality of health management services for the elderly aged 65 years and older in national essential public health service project.Methods:Based on the data of county-level medical institutions in Henan Province from 2019 to 2024,the Random Forest Method was used to construct a counterfactual framework to predict the hospitalization expenses under the unmanaged scenario,and then the cost-benefit ratio(BCR)and net income were calculated.Time-dependent Cox proportional hazards model was used to evaluate the effect of health management on all-cause mortality and cardiovascular and cerebrovascular disease mortality in the elderly.Results:A total of 962 955 elderly patients were included,451 119(46.85%)were included in the management group.The average hospitalization cost of the management group was significantly lower than that of the non-management group(P<0.05).Except for 2020-2021,BCRS in 2019 and 2022-2024 were 6.34,2.05,4.45 and 6.60,respectively.The risk of all-cause death was reduced by 76.96%,and the risk of cardiovascular and cerebrovascular death was reduced by 75.57%in the elderly patients included in the management group compared with those not included in the management group.Suggestions:It is necessary to establish a health outcomes-based evaluation system and promote the transformation and upgrading of the service model from single chronic disease management to"integrated health services with multi-disease management".
