対策型胃内視鏡検診の費用対効果

Cost-effectiveness of Organized Endoscopic Screening Program for Gastric Cancer

要旨●対策型検診の費用対効果の分析は医療技術評価の一部であり，効率性の観点から政策意思決定に有益な情報を与えることを目的とする．最近の胃内視鏡検診の費用対効果研究では，効果指標は統一されている一方で，考慮されている費用の範囲は研究によってかなり違う．政策意思決定に有益な費用対効果研究では，検診という医療技術の特性を理解し，事業全体の運営費用，受診者の時間費用への影響，受診率の費用に対する影響を考えた分析を行う必要がある．そのためには，地域の特性が考慮可能で実施主体の政策立案に役立つ医療経済モデルを構築することが必要となる．

　Cost-effectiveness analysis of organized cancer screening forms a part of the health technology assessment. These programs aim to provide useful information for policy decision-making in terms of efficiency. Outcome measures were unified in recent researches. However, the cost ranges considered in the analyses were diverse. For the application of cost-effective analysis for policy decision-making, the cost of the entire program, the time and expense incurred on the participants, and the impact of the participation rate should be considered based on a deeper understanding of the technological features of a particular screening method. The construction of health-economic models that consider the regional characteristics is essential to provide useful information to policy makers.