Giảm thiểu khủng hoảng ma túy heroin tại Baltimore, MD, Hoa Kỳ: phân tích chi phí-lợi ích của một cơ sở tiêm chích có giám sát giả định

Harm Reduction Journal - Tập 14 - Trang 1-14 - 2017
Amos Irwin1,2, Ehsan Jozaghi3,4, Brian W. Weir5, Sean T. Allen5, Andrew Lindsay5, Susan G. Sherman6
1Law Enforcement Action Partnership, Silver Spring, USA
2Criminal Justice Policy Foundation, Silver Spring, USA
3British Columbia Centre for Disease Control, University of British Columbia, Vancouver, Canada
4School of Population and Public Health, University of British Columbia, Baltimore, USA
5Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA
6Criminal Justice Policy Foundation, Amherst College, Silver Spring, USA

Tóm tắt

Tại Baltimore, MD, như nhiều thành phố khác trên toàn nước Mỹ, tỷ lệ quá liều đang gia tăng do cả sự gia tăng lạm dụng opioid theo toa và sự xuất hiện của fentanyl cùng các loại opioid tổng hợp khác trên thị trường ma túy. Các cơ sở tiêm chích có giám sát (SIFs) là một can thiệp y tế công cộng được triển khai rộng rãi trên toàn thế giới, với 97 cơ sở hiện có tại 11 quốc gia. Nghiên cứu đã ghi nhận những lợi ích về sức khỏe cộng đồng, xã hội và kinh tế của SIFs, tuy nhiên, không có cơ sở nào tồn tại tại Hoa Kỳ. Mục đích của nghiên cứu này là mô hình hóa chi phí và lợi ích về sức khỏe cũng như tài chính của một SIF giả định tại Baltimore. Chúng tôi ước tính lợi ích bằng cách sử dụng dữ liệu y tế địa phương và dữ liệu về tác động của các SIF hiện có trong các mô hình cho sáu kết quả: phòng ngừa lây truyền virus HIV, lây truyền virus viêm gan C, nhiễm trùng da và mô mềm, tỷ lệ tử vong do quá liều, và chi phí y tế liên quan đến quá liều cũng như tăng cường điều trị bằng thuốc hỗ trợ cho sự phụ thuộc opioid. Chúng tôi dự đoán rằng với chi phí hàng năm là 1.8 triệu đô la, một SIF duy nhất sẽ tạo ra khoản tiết kiệm lên đến 7.8 triệu đô la, ngăn chặn 3.7 ca nhiễm HIV, 21 ca nhiễm viêm gan C, 374 ngày nằm viện do nhiễm trùng da và mô mềm, 5.9 ca tử vong do quá liều, 108 cuộc gọi cứu thương liên quan đến quá liều, 78 lần thăm khám tại phòng cấp cứu và 27 ca nhập viện, trong khi đưa thêm 121 người vào liệu pháp điều trị. Chúng tôi kết luận rằng một SIF sẽ cực kỳ hiệu quả về chi phí và sẽ mang lại lợi ích đáng kể cho sức khỏe cộng đồng cũng như kinh tế cho thành phố Baltimore.

Từ khóa

#SIF #ma túy #chi phí-lợi ích #sức khỏe cộng đồng #Baltimore #opioid #cứu thương #viêm gan C #HIV.

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