Construction method of regional AIDS prevention and control efficiency development prediction model

Abstract

The invention provides a method for establishing a regional AIDS prevention and control efficiency development prediction model, which comprises the following steps of: A, obtaining an AIDS disability adjustment life year through AIDS disease burden measurement and calculation; b, obtaining the AIDS quality adjustment life year through AIDS health effectiveness measurement and calculation; step C, obtaining direct economic burden and indirect economic burden caused by AIDS through AIDS disease economic burden measurement and calculation; and step D, forming a regional AIDS prevention and control efficiency development prediction model through multi-dimensional measurement and calculation and integration. The AIDS comprehensive evaluation overall situation and the AIDS prevention and control work effect overview can be obtained, the AIDS prevention and control efficiency of a survey area can be comprehensively measured, comparison can be carried out in different areas, the range and strength of decision support evidences are expanded, the prevention and control efficiency is improved, the economic burden is reduced, and therefore AIDS propagation and influence are more effectively controlled.

Description

Technical Field

[0001] The invention provides a method for constructing a regional AIDS prevention and control efficiency development prediction model, and belongs to the technical field of public health management and economics. Background Art

[0002] With the advancement of antiviral treatment and the improvement of treatment effects, HIV infection has changed from a "terminal illness" to a chronic infectious disease. HIV-infected people / AIDS patients can achieve a life expectancy close to that of "normal people" under effective antiviral treatment and health management throughout the life cycle. However, as AIDS prevention and control enters a new era, there is still a lack of evaluation and prediction of the efficiency of AIDS prevention and control. Currently, there are only epidemiological indicators such as incidence, prevalence, and mortality, which cannot fully reflect the full range of effects brought about by integrated prevention and control measures. The evaluation of the prevention and control efficiency under the comprehensive response bio-psycho-social medical model is insufficient, and the decision-making evidence formed is limited.

[0003] Therefore, it is necessary to improve the prior art. Summary of the invention

[0004] The present invention provides a method for constructing a regional AIDS prevention and control efficiency development prediction model to form a regional prevention and control efficiency development prediction under comprehensive AIDS prevention and control, comprising the following steps:

[0005] Step A: Obtain AIDS disability-adjusted life years through disease burden measurement;

[0006] Step B: Obtain AIDS quality-adjusted life years through health utility measurement;

[0007] Step C: Obtain the direct and indirect economic burdens caused by AIDS through disease economic burden calculation;

[0008] Step D: Through multi-dimensional measurement and integration, a regional AIDS prevention and control efficiency development prediction model is formed.

[0009] Furthermore, the step A comprises the following steps:

[0010] Step A1: Obtain AIDS case data and death data of the population in the target area and divide them into the following age groups: under 1 year old, 1-4 years old, 5-9 years old, 10-14 years old, 15-19 years old, 80-84 years old, and over 85 years old;

[0011] Step A2: Calculate the average age of death and average age of onset for each age group. The average age of death for each age group = the sum of the ages of the number of deaths in each age group / the number of deaths; the average age of onset for each age group = the sum of the ages of onset of patients in each age group / the number of patients, where the age of onset is the age at which AIDS is diagnosed;

[0012] Step A3: Use the disease burden calculation Excel template published by the World Health Organization and do the following:

[0013] Step A31: According to the latest version of the pharmacoeconomic evaluation guidelines, the discount rate of the quality-adjusted life year (DALY) part in the step A3 template is set to 0.05, and the other parameters remain unchanged;

[0014] Step A32: In the A.YLL section of the template in step A3, input the population, number of deaths, and average age of death of the corresponding age group to obtain the YLL of life lost due to premature death of each age group, the total YLL of life lost due to premature death, and the YLL rate; where YLL rate = YLL / corresponding population × 100,000 / 100,000, which is used to reflect the proportion of life lost due to disease relative to the total population; YLL of life lost due to premature death is obtained by the following calculation:

[0015] Taking into account the disability weight and time discount, the calculation formula of YLL is:

[0016]

[0017] In the formula, D is the disability weight, which is 1, where 0 indicates health and 1 indicates death; k is the age weight adjustment coefficient, which is 1; C is the continuity adjustment coefficient, which is 0.1658; e is the base of the natural logarithm, which is 2.71828; β is the age weight coefficient, which is 0.04; r is the discount rate, which is 0.05 according to the latest version of the pharmacoeconomic evaluation guidelines; L indicates the duration of disability or the time lost due to premature death; α is the age of death; where L is calculated using the standard life expectancy years lost method;

[0018] Step A33: For the B.YLD portion of the template in step A3, calculate YLD using the following method:

[0019] Method 1: In the B.YLD section of the template in step A3, enter the population, number of cases, average age of onset, average course of disease, and disability weight of the corresponding age group to obtain the YLD of healthy life lost due to disability in each age group, the total YLD of healthy life lost due to disability, and the YLD rate. Among them, the YLD rate = YLD / corresponding population × 100,000 / 100,000, which is used to reflect the proportion of years of disability loss due to disease or health conditions to the total number of years for a specific population or the total population, as follows:

[0020] Taking into account the disability weight and time discount, the calculation formula for YLD is:

[0021]

[0022] Wherein, D is the disability weight, which is 0.231; k is the age weight adjustment coefficient, which is 1; C is the continuous adjustment coefficient, which is 0.1658; e is the base of the natural logarithm, which is 2.71828; β is the age weight coefficient, which is 0.04; r is the discount rate, which is 0.05 according to the 2020 Pharmacoeconomic Evaluation Guidelines; L is the course of disability, which is 1; α is the actual age of onset of the patient;

[0023] Method 2: Indirect estimation using the following formula from the Global Burden of Disease (GBD) study: YLD 目标(i，j) =YLL 目标(i，j) / YLL 参照(i，j) ×YLD 参照(i，j)

[0024] Where: YLD 目标(i，j) YLL is the indirect estimate of the number of healthy life years lost due to disability in the target area. 目标(i，j) Years of life lost due to premature deaths in target areas, YLL 参照(i，j) Years of life lost due to premature death in the reference area of ​​the GBD study, YLD 参照(i，j) The years of healthy life lost due to disability in the reference area of ​​the GBD study;

[0025] Step A34: The DALYs=YLL+YLD part of C.Total in the template of step A3 is used to generate the disability-adjusted life years DALY and the total disability-adjusted life years DALYS for the corresponding age group, wherein the years of healthy life lost due to disability YLD are obtained by the indirect method of step A33.

[0026] Further, the step B comprises the following steps:

[0027] Step B1, download and obtain the EQ-5D-3L or EQ-5D-5L scale from the official website. The SF-6D scale is directly converted to the SF-6D scale or the SF-12 scale;

[0028] Step B2: Conduct an on-site questionnaire survey on the subjects using the EQ-5D-3L / EQ-5D-5L or SF-6D scale to obtain the scale measurement scores;

[0029] Step B3, calculating the scale measurement score of step B2 to obtain a health utility score;

[0030] The health utility score in step B4 and step B3 is the health utility value. The expected life expectancy is multiplied by the health utility value to obtain the quality-adjusted life year (QALY).

[0031] Preferably, the step B3 comprises the following steps:

[0032] Step B31, using the EQ-5D-3L scale, converting the measurement scores according to the EQ-5D-3L utility scoring system for the Chinese population;

[0033] Step B32, using the EQ-5D-5L scale, converting the measurement scores according to the EQ-5D-5L utility scoring system for the Chinese population;

[0034] Step B33: Calculate the health utility score using the health utility scoring system based on the British population proposed by Brazier et al.

[0035] Furthermore, the step C comprises the following steps:

[0036] Step C1: Calculate the direct economic burden of AIDS by multiplying the average cost of different types of AIDS prevention and treatment services by the number of times the corresponding AIDS prevention and treatment services are used to obtain the average treatment cost;

[0037] The direct economic burden is calculated by multiplying the average treatment cost by the disease incidence or prevalence using the following formula:

[0038]

[0039] In the formula, P is the unit price of each AIDS prevention and treatment service, and n is the number of times;

[0040] The direct economic burden calculation specifically includes the following steps:

[0041] Step C11: Calculate the direct economic burden of HIV infection. The direct economic burden of AIDS is defined as the lifelong antiviral treatment costs of HIV or AIDS, which is calculated by adding the lifelong antiviral treatment costs, routine follow-up testing costs, adverse reaction treatment costs, and opportunistic infection prevention and treatment costs;

[0042] Step C12: Collect the above costs by conducting special surveys or literature research, including antiviral treatment costs, routine testing and follow-up costs, adverse reaction treatment costs, and opportunistic infection prevention costs. Add the above costs to obtain the direct economic burden estimate. When calculating in this step, choose the social prevention perspective, that is, calculate based on the social prevention perspective;

[0043] Step C13: If the infection occurred during infancy, the direct costs during childhood should be corrected to 1.75:1 with the direct costs for adults;

[0044] Step C2: Calculate the indirect economic burden, using the human capital method, which is a method for calculating the indirect economic burden based on the loss of income caused by the loss of time due to illness, disability or death, specifically including: Step C21, calculating the indirect economic losses of HIV-infected persons due to mother-to-child transmission, Step C22, calculating the indirect economic losses of HIV-infected persons due to intravenous drug use, and Step C23, calculating the indirect economic losses of HIV-infected persons due to sexual transmission, where:

[0045] Step C21: Calculate the indirect economic losses of HIV-infected persons due to mother-to-child transmission. The indirect economic burden caused by HIV infection in an infant is calculated according to the following formula:

[0046]

[0047] E=E Normal -E HIV

[0048] In the formula, Y=18 means that the age is 18 years old. The starting year of the calculation is set as 2015. The present value of labor income from 2015 to Y is calculated. GDP (Y 2015 ) represents the per capita GDP of Yunnan Province in 2015. The year substituted into the formula can be updated and adjusted according to the specific calculation year. HIV represents the present value of labor income of HIV / AIDS patients, E Normal represents the present value of a normal person’s labor income, C income represents the income distribution coefficient, C discount represents the discount rate; the specific calculation steps are as follows:

[0049] C21-1. When using the formula of C21 to calculate, it is assumed that the effective working time of a normal person is between 18 and 60 years old. The potential loss of effective working time is: 60-average infection age;

[0050] C21-2. Assuming that the life expectancy of children infected with HIV is 28.79 years, the effective working time of HIV-infected children due to mother-to-child transmission at birth is calculated to be: 28.79-18 = 10.79 years, and the potential loss of effective working time is: 60-28.79 = 31.27 years;

[0051] C21-3. When using the formula of C21 for calculation, HIV / AIDS patients have labor force loss and unemployment due to illness. Therefore, it is necessary to use the unemployment rate to weight the labor force value in order to estimate the loss of labor force value caused by HIV infection or AIDS. According to the World Labor Organization, the unemployment rate of HIV-infected people is more than 3 times the average unemployment rate of the country, that is, unemployment rate = average unemployment rate of the country or region × (≥3). In the estimation, the unemployment rate of HIV / AIDS patients is set to 5 times the average unemployment rate of my country. If HIV infection occurs during infancy due to mother-to-child transmission, the unemployment rate of the child when he grows up to the effective working age is: 4.1% × 5 = 20.5%;

[0052] C21-4. When calculating the present value of the lifelong labor income of the infant infected with HIV due to mother-to-child transmission in step C21-3, according to the 2020 edition of the Guidelines for Pharmacoeconomic Evaluation, the discount rate is 5%, and the present value of labor income in each year is discounted and converted into the present value of RMB in 2015. The base year used can be adjusted according to actual conditions;

[0053] C21-5. In the process of calculating the present value of labor income, the growth of gross domestic product is taken into account. The average annual growth rate of per capita GDP of 8.5% in Yunnan Province is used to correct the present value of each year's income. In actual calculation, the per capita GDP growth rate can be adjusted according to actual conditions;

[0054] C21-6. Use the income distribution coefficient to weight the GDP per capita of each age group;

[0055] C21-7. Subtract the present value of labor income E of normal children of each age group after they grow up to effective working age from the present value of labor income of HIV-infected children at effective working age to obtain the indirect economic burden of HIV infection in infants;

[0056] Step C22: Calculate the indirect economic loss of HIV-infected persons due to intravenous drug use. The indirect economic burden caused by HIV infection in one person due to intravenous drug use is calculated according to the following formula:

[0057]

[0058] E=E Normal -E HIV

[0059] In the formula, Y represents the estimated year, 2020 is set as the starting year, and the present value of labor income from year Y to 2020 is estimated. The year substituted into the formula can be updated and adjusted according to the specific calculation year; E HIVE represents the present value of labor income of HIV-infected / AIDS patients; normal represents the present value of a normal person’s labor income; C income represents the income distribution coefficient, C discount represents the discount rate; the specific calculation steps are as follows:

[0060] C22-1. When using the formula of C22 for calculation, it is first assumed that the effective working time of a normal person is 18-60 years old. It is assumed that the average age of HIV infection caused by intravenous drug use is 38 years old. The average age is replaced and adjusted according to the actual monitoring situation. It is assumed that the life expectancy of adult HIV-infected people is 75.1 years old. The expected age can be adjusted according to the actual situation. The potential loss of effective working time is: 60-average infection age. If HIV is infected by intravenous drug use at the age of 38, the effective working time is: 60-38=22 years;

[0061] C22-2. HIV-infected / AIDS patients suffer from labor force loss and unemployment due to illness. In the calculation process, the unemployment rate needs to be used to weight the labor force value in order to estimate the loss of labor force value caused by HIV infection or AIDS: First, according to the World Labor Organization's estimate, the unemployment rate of HIV-infected people is more than 3 times the average unemployment rate of the country, that is, unemployment rate = average unemployment rate of the country or region × (≥3). In the estimation, the unemployment rate of HIV-infected / AIDS patients is set at 5 times the average unemployment rate of my country. Therefore, if HIV is infected through intravenous injection due to drug abuse and the infected age is 38 years old, the unemployment rate in the effective working age stage is 4.1% × 5 = 20.5%;

[0062] C22-3. When calculating the present value of lifetime labor income of the infected person infected with HIV through intravenous drug abuse at the age of 38 in step C22-2, according to the 2020 edition of the Pharmacoeconomic Evaluation Guidelines, the discount rate is 5%, and the present value of labor income in each year is discounted and converted into the present value of RMB in 2020. The base year used can be adjusted according to actual conditions;

[0063] C22-4. In the process of calculating the present value of labor income, the growth of gross domestic product is taken into account. The average annual growth rate of per capita GDP of 8.1% in Yunnan Province is used to correct the present value of each year's income. In actual calculation, the per capita GDP growth rate can be adjusted according to actual conditions;

[0064] C22-5. Use the income distribution coefficients of different age groups to weight the GDP per capita of each age group;

[0065] C22-6. Subtract the present value of the labor income of a normal person from the present value of the labor income of a person infected with HIV / AIDS who is infected through intravenous drug use to obtain the indirect economic loss of a person infected with HIV at the age of 38 due to intravenous drug use;

[0066] Step C23: Calculate the indirect economic losses of HIV-infected persons through sexual transmission. The indirect economic burden caused by HIV infection in one person through sexual transmission is calculated according to the following formula:

[0067]

[0068] E=E Normal -E HIV

[0069] In the formula, Y represents the estimated year, 2020 is set as the starting year, and the present value of labor income from year Y to 2020 is estimated; the year substituted into the formula is updated and adjusted according to the specific calculation year; E HIV E represents the present value of labor income of HIV-infected / AIDS patients; normal represents the present value of a normal person’s labor income; C income represents the income distribution coefficient, C discount represents the discount rate; the specific calculation steps are as follows:

[0070] C23-1. When using the formula in step C23 for calculation, it is first assumed that the effective working time of a normal person is 18-60 years old, and that the average age of HIV infection due to sexual transmission is 44 years old. The average age is replaced and adjusted based on the actual monitoring situation. It is assumed that the life expectancy of adult HIV-infected persons is 75.1 years old. The expected age is adjusted based on actual changes. The potential loss of effective working time is: 60-average infection age; if HIV is infected due to sexual transmission at the age of 44, the effective working time is: 60-44=16 years;

[0071] C23-2. HIV / AIDS patients suffer from labor force loss and unemployment due to illness. In the calculation process, the unemployment rate is used to weight the labor force value to estimate the loss of labor force value caused by HIV infection or AIDS: According to the World Labor Organization, the unemployment rate of HIV-infected people is more than 3 times the average unemployment rate of the country, that is, unemployment rate = average unemployment rate of the country or region × (≥3). In the estimation, the unemployment rate of HIV / AIDS patients is set to 5 times the average unemployment rate of my country. If HIV infection is caused by sexual transmission and the infection age is 44 years old, the unemployment rate in the effective working age stage is 4.1% × 5 = 20.5%;

[0072] C23-3. When calculating the present value of the lifetime labor income of the infected person at the age of 44 after being infected with HIV through sexual transmission in step C23-2, according to the 2020 edition of the Pharmacoeconomic Evaluation Guidelines, the discount rate is 5%, and the present value of labor income in each year is discounted and converted into the present value of RMB in 2020. The base year used can be adjusted according to actual conditions;

[0073] C23-4. In the process of calculating the present value of labor income, the growth of gross domestic product is taken into account. In this calculation, the average annual growth rate of per capita GDP of 8.1% in Yunnan Province is used to correct the present value of each year's income. In actual calculation, the per capita GDP growth rate can be adjusted according to actual conditions;

[0074] C23-5. Use the income distribution coefficients of different age groups to weight the GDP per capita of each age group;

[0075] C23-6. Subtract the present value of the labor income of a normal person from the present value of the labor income of a person infected with HIV / AIDS due to sexual transmission to obtain the indirect economic loss of a person infected with HIV due to sexual transmission at the age of 44.

[0076] Further, the step D comprises the following steps:

[0077] Step D1: Explain the results of the AIDS burden calculation, including: (1) Compare the differences in the AIDS burden at different times, in different regions, and under different demographic characteristics such as sexually transmitted diseases, age, and transmission routes, implement hierarchical management of regions facing the AIDS burden, and identify the population facing the highest disease burden; (2) Compare the composition of the AIDS burden, determine the distribution of the disease burden caused by death and the disease burden caused by disability, and clarify the main prevention and control areas in different periods and regions;

[0078] Step D2: Explain the results of the AIDS health utility and quality-adjusted life years calculations, including: (1) the closer the health utility value is to 1, the better the health status; (2) compare the health utility values ​​under different AIDS prevention and control strategies; (3) Quality-adjusted life years are the outcome indicators of health-utility analysis in health economics evaluation. By conducting cost-utility analysis, it provides evidence support for the priority selection of AIDS prevention and control strategies;

[0079] Step D3: Explain the results of the calculation of the economic burden of AIDS, including: (1) The total economic burden of AIDS is calculated by adding the direct economic burden and the indirect economic burden; (2) The economic burden of AIDS can be used as an estimate of the economic losses avoided by the implementation of AIDS prevention and control measures. The return on investment (ROI) is calculated by taking the ratio of the total avoided economic losses to the total investment. ROI represents the economic benefit value obtained for every 1 yuan of investment, thereby quantifying the effect of the evaluated AIDS prevention and control measures; (3) The total economic burden of AIDS can be used as an outcome indicator of cost-effectiveness analysis in health economic evaluation. By conducting cost-effectiveness analysis, it provides evidence support for the priority selection of AIDS prevention and control strategies;

[0080] Step D4: Based on the above explanation, a comprehensive evaluation of regional AIDS prevention and control efficiency is formed, including a macro-level prediction of prevention and control efficiency development based on AIDS disease burden and economic burden, and a micro-level prediction of prevention and control efficiency development based on health utility.

[0081] Through the above technical solution, the present invention has the following advantages and technical effects:

[0082] 1. The present invention can be used to obtain a prediction of the efficiency development of the comprehensive AIDS prevention and control model, forming an overall picture of the comprehensive evaluation of AIDS and an overview of the effectiveness of AIDS prevention and control work in the new stage of AIDS prevention and control;

[0083] 2. Based on the concept of the biopsychosocial medical model, the present invention integrates multiple dimensions to establish a regional AIDS development prediction model to supplement the existing single evaluation system and prediction dimension. The constructed model can comprehensively measure the efficiency of AIDS prevention and control in the surveyed area, and can be compared between different regions, thereby expanding the scope and strength of decision-making support evidence.

[0084] 2. This model can effectively measure the effectiveness of prevention and control measures in reducing disease burden and improving quality of life, and form a comprehensive evaluation of regional AIDS prevention and control efficiency, including forming a macro-prevention efficiency development forecast from the AIDS disease burden and economic burden, and forming a micro-individual-level prevention and control efficiency development forecast from health utility, revealing the long-term economic benefits of prevention and control measures and strategies for optimizing resource allocation. Continuously optimizing prevention and control strategies and resource allocation can improve prevention and control efficiency, reduce economic burden, and thus more effectively control the spread and impact of AIDS.

[0085] 3. The system method of the present invention is clear, the measurement data is well accessible, the measurement perspective is comprehensive, and the applicability is strong.

[0086] 4. The calculation results can provide evidence support for decision-makers in formulating AIDS prevention and control strategies.

[0087] 5. The estimation ideas and methods can be used as reference for colleagues in the fields of health economics and epidemiology.

[0088] The present invention can be used to obtain a prediction of the efficiency development of the comprehensive AIDS prevention and control model, and to form an overall comprehensive AIDS evaluation and an overview of the effectiveness of AIDS prevention and control work in the new stage of AIDS prevention and control.

[0089] Based on the concept of the biopsychosocial medical model, the present invention integrates multiple dimensions to establish a regional AIDS development prediction model to supplement the existing evaluation system and the shortcomings of the prediction dimension. The constructed model can comprehensively measure the prevention and control efficiency of regional AIDS, and can be compared between different regions to expand the scope and strength of decision-making support evidence.

[0090] This model can effectively measure the effectiveness of prevention and control measures in reducing disease burden and improving quality of life, and form a comprehensive evaluation of regional AIDS prevention and control efficiency, including: forming a macro-prevention and control efficiency development forecast from the AIDS disease burden and economic burden, forming a micro-individual-level prevention and control efficiency development forecast from health utility, revealing the long-term economic benefits of prevention and control measures and strategies for optimizing resource allocation, continuously optimizing prevention and control strategies and resource allocation, improving prevention and control efficiency, reducing economic burden, and thus more effectively controlling the spread and impact of AIDS.

[0091] The system method of the present invention is clear, the measurement data is accessible, the measurement perspective is comprehensive, and the applicability is strong. The measurement results can provide evidence support for the formulation of AIDS prevention and control strategies by decision-making departments. The measurement ideas and methods can be used as reference and reference for peers in the fields of health economics and epidemiology. BRIEF DESCRIPTION OF THE DRAWINGS

[0092] Figure 1 This is a schematic diagram of the EXCEL table for WHO disease burden estimation;

[0093] Figure 2 This is the SF-6D scale chart;

[0094] Figure 3 This is the SF-12 scale chart;

[0095] Figure 4 This is a diagram of the EQ-5D-3L utility score system for the Chinese population;

[0096] Figure 5 This is a diagram of the EQ-5D-5L utility score system for the Chinese population;

[0097] Figure 6 This is the SF-6D utility points system diagram;

[0098] Figure 7 This is the correspondence diagram between the items of SF-12 and SF-6D;

[0099] Figure 8 This is the income distribution coefficient diagram. DETAILED DESCRIPTION

[0100] The present invention will be further described below by way of examples.

[0101] Example 1

[0102] The method for constructing a regional AIDS prevention and control efficiency development prediction model provided by the present invention comprises the following steps:

[0103] Step A: Obtain AIDS disability-adjusted life years through AIDS disease burden measurement;

[0104] Step B: Obtain AIDS quality-adjusted life years through AIDS health utility measurement;

[0105] Step C: Obtain the direct and indirect economic burdens caused by AIDS through the calculation of the economic burden of AIDS;

[0106] Step D: Form a regional AIDS prevention and control efficiency development prediction model through multi-dimensional measurement and integration;

[0107] Step A includes the following steps:

[0108] Step A1: Obtain AIDS case data and death data of the population in the target area and divide them into the following age groups: under 1 year old, 1-4 years old, 5-9 years old, 10-14 years old, 15-19 years old, 80-84 years old, and over 85 years old;

[0109] Step A2: Calculate the average age of death and average age of onset for each age group, where: average age of death for each age group = sum of ages of deaths in each age group / number of deaths; average age of onset for each age group = sum of ages of onset of patients in each age group / number of patients, where onset age is the age at the time of diagnosis of AIDS;

[0110] Step A3: Use the disease burden calculation Excel template published by the World Health Organization (see Figure 1 ), do the following:

[0111] Step A31: According to the latest version of the pharmacoeconomic evaluation guidelines, the discount rate of the DALY Parameters section in the step A3 template is set to 0.05, and the other parameters remain unchanged;

[0112] Step A32: In the A.YLL template of the step A3 template, input the number of people, number of deaths, and average age of death of the corresponding age group to obtain the YLL of life lost due to premature death of each age group, the total YLL of life lost due to premature death, and the YLL rate; where YLL rate = YLL / corresponding population × 100,000 / 100,000, which is used to reflect the proportion of life lost due to disease relative to the total population; YLL of life lost due to premature death is obtained by the following calculation: Considering the disability weight and time discount, the calculation formula of YLL of life lost due to premature death is:

[0113]

[0114] In the formula, D is the disability weight, with values ​​of 0 and 1, where 0 indicates health and 1 indicates death; k is the age weight adjustment coefficient, with a value of 1; C is the continuous adjustment coefficient, with a value of 0.1658; e is the base of the natural logarithm, with a value of 2.71828; β is the age weight coefficient, with a value of 0.04; r is the discount rate, which is 0.05 according to the latest version of the pharmacoeconomic evaluation guidelines; L represents the time lost due to premature death; α is the age of death; where: L is calculated using the method of standard life expectancy years lost (standard life expectancy see Table 1 Western Life Table No. 26), where the life expectancy is 80.0 years for men and 82.5 years for women;

[0115] Table 1 Western life table No. 26

[0116]

[0117] Step A33: For the B.YLD section in the Step A3 template:

[0118] Calculate YLD using Method 1:

[0119] In the B.YLD template of step A3, input the number of people in the corresponding age group, the number of cases, the average age of onset, the average course of disease, and the disability weight to obtain the YLD of healthy life lost due to disability in each age group, the total YLD of healthy life lost due to disability, and the YLD rate; where YLD rate = YLD / corresponding population × 100,000 / 100,000, which is used to reflect the proportion of years of disability loss due to disease or health conditions to the total number of years for a specific population or the total population, as follows: Considering the disability weight and time discount, the calculation formula of YLD is:

[0120]

[0121] Wherein, D is the disability weight, which is 0.231; k is the age weight adjustment coefficient, which is 1; C is the continuous adjustment coefficient, which is 0.1658; e is the base of the natural logarithm, which is 2.71828; β is the age weight coefficient, which is 0.04; r is the discount rate, which is 0.05 according to the 2020 Pharmacoeconomic Evaluation Guidelines; L is the course of disability, which is 1; α is the actual age of onset of the patient;

[0122] Calculate YLD using method 2:

[0123] It is indirectly estimated using the following formula from the Global Burden of Disease (GBD) study:

[0124] YLD 目标(i，j) =YLL 目标(i，j) / YLL 参照(i，j) ×YLD 参照(i，j)

[0125] Where: YLD 目标(i，j) The target disability-related healthy life years (YLL) is indirectly estimated. 目标(i，j) Years of life lost due to premature death, YLL 参照(i，j) YLD is the years of life lost due to premature death in the reference area in GBD-related studies. 参照(i，j) Years of healthy life lost due to disability in the reference area;

[0126] Step A34: in the part C.Total DALYS=YLL+YLD in the template of step A3, generate the DALY and the total DALYS of the corresponding age group; wherein the YLD of healthy life lost due to disability is obtained by step A33;

[0127] Step B includes the following steps:

[0128] Step B1. From the official website https: / / euroqol.org / Download and obtain the EQ-5D-3L or EQ-5D-5L scales. The SF-6D scale can be directly measured and converted using the SF-6D or the SF-12 scale. The SF-6D and SF-12 scales can be found at Figure 2 and Figure 3 As shown;

[0129] Step B2: Conduct an on-site questionnaire survey on the subjects using the EQ-5D-3L / EQ-5D-5L or SF-6D scale to obtain the scale measurement scores;

[0130] Step B3: Calculate the scale measurement score of step B2 to obtain the health utility score; the specific steps are as follows:

[0131] Step B31: Use the EQ-5D-3L scale to convert the measurement scores according to the EQ-5D-3L utility scoring system for the Chinese population. The EQ-5D-3L utility scoring system for the Chinese population is shown in Figure 4 ; Figure 4 In the formula, C is a constant term, MO2, SC2, UA2, PD2 and AD2 indicate that the second option is selected in the five dimensions: mobility MO, self-care SC, daily activities UA, pain / discomfort PD, anxiety / depression AD; MO3, SC3, UA3, PD3 and AD3 indicate that the third option is selected in the five dimensions;

[0132] For example, when a survey subject selects MO2, SC0, UA0, PD2, and AD in the five dimensions:

[0133] When the 2014 version is used and the third option is selected for any dimension, the score is calculated by subtracting the N3 value:

[0134] 1-C value 0.039-0.099-0-0-0.092-0.205-N3 value 0.022=0.543;

[0135] When using the 2018 version, the score is calculated as:

[0136] 1-0.0766-0-0-0.0274-0.1771=0.7189;

[0137] When all the options in the five dimensions are 1, that is, 11111, it means that there is no difficulty in any dimension, and the score is 1;

[0138] According to the calculation principles of different versions of the utility point system, if the 2014 version of the utility point system is used, the health utility score ranges from -0.149 points to 1 point; if the 2018 version of the utility point system is used, the health utility score ranges from 0.1702 points to 1 point;

[0139] Step B32: Use the EQ-5D-5L scale to convert the measurement scores according to the EQ-5D-5L utility scoring system for the Chinese population. The EQ-5D-5L utility scoring system for the Chinese population is shown in Figure 5, where C represents a constant term, MO2, SC2, UA2, PD2 and AD2 represent the second option selected in the five dimensions: mobility MO, self-care SC, daily activities UA, pain / discomfort PD, anxiety / depression AD; MO3, SC3, UA3, PD3 and AD3 represent the third option selected in the five dimensions; MO4, SC4, UA4, PD4 and AD4 represent the fourth option selected in the five dimensions; MO5, SC5, UA5, PD5 and AD5 represent the fifth option selected in the five dimensions;

[0140] For example, when a respondent selects MO2, SC5, UA1, PD4, and AD3 options in the five dimensions, that is, the second option in the MO dimension of mobility, the fifth option in the SC dimension of self-care, the first dimension in the UA dimension of daily activities, the fifth option in the PD dimension of pain / discomfort, and the fifth dimension in the AD dimension of anxiety / depression, the score is calculated as:

[0141] 1-0.066-0.253-0-0.252-0.118=0.311;

[0142] When all the options in the five dimensions are 1, that is, 11111, it means that there is no difficulty in any dimension, and the score is 1 point; the health utility score ranges from -0.391 points to 1 point;

[0143] Step B33: Use the health utility scoring system based on the British population proposed by Brazier et al. [2] When calculating the health utility score for the SF-6D scale, the SF-12 measurement is first converted to SF-6D. The utility score calculation is shown in Figure 6 The conversion method is shown in Figure 7 As shown; the health utility score uses the following formula:

[0144] U=1+the value corresponding to each dimension option+the adjustment coefficient Most value

[0145] When the worst option is selected for any dimension, the final score must be added with the adjustment coefficient Most value = -0.085;

[0146] For example, the selection combination of each dimension of SF-6D is "223123", which means that 2 is selected in the physical function dimension, 2 is selected in the role limitation dimension, 3 is selected in the social function dimension, 1 is selected in the pain dimension, 2 is selected in the mental health dimension, and 3 is selected in the vitality dimension. Then the health utility score is: 1-0.012-0.068-0.069-0-0.004-0.065-0.085=0.697;

[0147] The health utility score of step B4 and step B3 is the health utility value. The expected life span is multiplied by the health utility value to obtain the quality-adjusted life years (QALYs).

[0148] Step C includes the following steps:

[0149] Step C1: Calculate the direct economic burden of AIDS by multiplying the average cost of different types of AIDS prevention and treatment services by the number of times the corresponding AIDS prevention and treatment services are used to obtain the average treatment cost. The direct economic burden is calculated according to the product of the average treatment cost and the disease incidence (prevalence) using the following formula:

[0150]

[0151] In the formula, P is the unit price of each medical item, and n is the number of times;

[0152] The direct economic burden calculation specifically includes the following steps:

[0153] Step C11, calculating the direct economic burden of HIV infection. The direct economic burden of AIDS is defined as the lifelong antiviral treatment costs of HIV or AIDS, which is calculated by adding the lifelong antiviral treatment costs, routine follow-up testing costs, adverse reaction treatment costs, and opportunistic infection prevention and treatment costs;

[0154] Step C12: Collect the above expenses by conducting special surveys or literature research, including antiviral treatment costs, routine testing and follow-up costs, adverse reaction treatment costs, and opportunistic infection prevention costs, and add the above costs to obtain the direct economic burden estimate. When calculating in this step, it is necessary to pay attention to the selected measurement perspective. In the measurement of AIDS prevention and control efficiency, the social prevention perspective is usually selected. The above measurement is based on the social prevention perspective;

[0155] Step C13: If the infection occurred during infancy, the direct costs during childhood should be corrected to 1.75:1 with the direct costs for adults;

[0156] Step C2, calculating the indirect economic burden, using the human capital approach, which is a method for calculating the indirect economic burden based on the loss of income due to time lost due to illness, disability or death, specifically including: step C21, calculating the indirect economic losses of HIV-infected persons due to mother-to-child transmission, step C22, calculating the indirect economic losses of HIV-infected persons due to intravenous drug use, and step C23, calculating the indirect economic losses of HIV-infected persons due to sexual transmission, wherein:

[0157] Step C21: Calculate the indirect economic losses of HIV-infected persons due to mother-to-child transmission. The indirect economic burden caused by HIV infection in an infant is calculated according to the following formula:

[0158]

[0159] E=E Normal -E HIV

[0160] In the formula, Y=18 means that the age is 18 years old. The starting year of the calculation is set as 2015. The present value of labor income from 2015 to Y is calculated. GDP (Y 2015 ) represents the per capita GDP of Yunnan Province in 2015. The year substituted into the formula can be updated and adjusted according to the specific calculation year. HIV represents the present value of labor income of HIV / AIDS patients, E Normal represents the present value of a normal person’s labor income, C income represents the income distribution coefficient, C discount represents the discount rate; the specific calculation steps are as follows:

[0161] C21-1. When using the formula of C21 to calculate, it is assumed that the effective working time of a normal person is between 18 and 60 years old. The potential loss of effective working time is: 60-average infection age;

[0162] C21-2. Assuming that the life expectancy of children infected with HIV is 28.79 years, the effective working time of HIV-infected children due to mother-to-child transmission at birth is calculated to be: 28.79-18 = 10.79 years, and the potential loss of effective working time is: 60-28.79 = 31.27 years;

[0163] C21-3. When using the formula of C21 for calculation, HIV / AIDS patients have labor force loss and unemployment due to illness. Therefore, it is necessary to use the unemployment rate to weight the labor force value in order to estimate the loss of labor force value caused by HIV infection or AIDS. According to the World Labor Organization, the unemployment rate of HIV-infected people is more than 3 times the average unemployment rate of the country, that is, unemployment rate = average unemployment rate of the country or region × (≥3). In the estimation, the unemployment rate of HIV / AIDS patients is set to 5 times the average unemployment rate of my country. If HIV infection occurs during infancy due to mother-to-child transmission, the unemployment rate of the child when he grows up to the effective working age is: 4.1% × 5 = 20.5%;

[0164] C21-4. When calculating the present value of the lifelong labor income of the infant infected with HIV due to mother-to-child transmission in step C21-3, according to the 2020 edition of the Guidelines for Pharmacoeconomic Evaluation, the discount rate is 5%, and the present value of labor income in each year is discounted and converted into the present value of RMB in 2015. The base year used can be adjusted according to actual conditions;

[0165] C21-5. In the process of calculating the present value of labor income, the growth of gross domestic product is taken into account. The average annual growth rate of per capita GDP of 8.5% in Yunnan Province is used to correct the present value of each year's income. In actual calculation, the per capita GDP growth rate can be adjusted according to actual conditions;

[0166] C21-6. Use the income distribution coefficient to weight the GDP per capita of each age group;

[0167] C21-7. Subtract the present value of labor income E of normal children of each age group after they grow up to effective working age from the present value of labor income of HIV-infected children at effective working age to obtain the indirect economic burden of HIV infection in infants;

[0168] Step C22: Calculate the indirect economic loss of HIV-infected persons due to intravenous drug use. The indirect economic burden caused by HIV infection in one person due to intravenous drug use is calculated according to the following formula:

[0169]

[0170] E=E Normal -E HIV

[0171] In the formula, Y represents the estimated year, 2020 is set as the starting year, and the present value of labor income from year Y to 2020 is estimated. The year substituted into the formula can be updated and adjusted according to the specific calculation year; E HIV E represents the present value of labor income of HIV-infected / AIDS patients; normal represents the present value of a normal person’s labor income; C income represents the income distribution coefficient, C discount represents the discount rate; the specific calculation steps are as follows:

[0172] Step C22-1, when using the formula of C22 for calculation, it is first assumed that the effective working time of a normal person is 18-60 years old, and the average age of HIV infection caused by intravenous drug use is assumed to be 38 years old. The average age is replaced and adjusted according to the actual monitoring situation. It is assumed that the life expectancy of adult HIV-infected people is 75.1 years old. The expected age can be adjusted according to the actual situation. The potential loss of effective working time is: 60-average infection age. If HIV is infected by intravenous drug use at the age of 38, the effective working time is: 60-38=22 years;

[0173] Step C22-2, HIV-infected / AIDS patients have labor force loss and unemployment due to illness. In the calculation process, the unemployment rate needs to be used to weight the labor force value to estimate the loss of labor force value caused by HIV infection or AIDS: First, according to the World Labor Organization's estimate, the unemployment rate of HIV-infected people is more than 3 times the average unemployment rate of the country, that is, unemployment rate = average unemployment rate of the country or region × (≥3). In the estimation, the unemployment rate of HIV-infected / AIDS patients is set to 5 times the average unemployment rate of my country. Therefore, if HIV is infected through intravenous injection due to drug abuse and the infected age is 38 years old, the unemployment rate in the effective working age stage is 4.1% × 5 = 20.5%;

[0174] Step C22-3: When calculating the present value of lifetime labor income of the infected person infected with HIV through intravenous drug abuse at the age of 38 in step C22-2, according to the 2020 edition of the Pharmacoeconomic Evaluation Guidelines, the discount rate is 5%, and the present value of labor income in each year is discounted and converted into the present value of RMB in 2020. The base year used can be adjusted according to actual conditions;

[0175] Step C22-4: In the process of calculating the present value of labor income, the growth of gross domestic product is taken into account. The average annual growth rate of per capita GDP of 8.1% in Yunnan Province is used to correct the present value of each year's income. In actual calculation, the per capita GDP growth rate can be adjusted according to actual conditions;

[0176] Step C22-5: Use the income distribution coefficients of different age groups to weight the GDP per capita of each age group;

[0177] Step C22-6, subtract the present value of the labor income of a normal person from the present value of the labor income of a person infected with HIV / AIDS due to intravenous drug use, to obtain the indirect economic loss of a person infected with HIV due to intravenous drug use at the age of 38;

[0178] Step C23: Calculate the indirect economic losses of HIV-infected persons through sexual transmission. The indirect economic burden caused by HIV infection in one person through sexual transmission is calculated according to the following formula:

[0179]

[0180] E=E Normal -E HIV

[0181] In the formula, Y represents the estimated year, 2020 is set as the starting year, and the present value of labor income from year Y to 2020 is estimated; the year substituted into the formula is updated and adjusted according to the specific calculation year; E HIV E represents the present value of labor income of HIV-infected / AIDS patients; normal represents the present value of a normal person’s labor income; C income represents the income distribution coefficient, C discount represents the discount rate; the specific calculation steps are as follows:

[0182] Step C23-1. When calculating with the formula of step C23, it is first assumed that the effective working time of a normal person is 18-60 years old, and the average age of HIV infection due to sexual transmission is assumed to be 44 years old. The average age is replaced and adjusted according to the actual monitoring situation. It is assumed that the life expectancy of adult HIV-infected people is 75.1 years old. The expected age is adjusted according to the actual situation. The potential loss of effective working time is: 60-average infection age; if HIV is infected due to sexual transmission at the age of 44, the effective working time is: 60-44=16 years;

[0183] Step C23-2, HIV-infected persons / AIDS patients suffer from labor force loss and unemployment due to illness. In the calculation process, the unemployment rate is used to weight the labor force value to estimate the loss of labor force value caused by HIV infection or AIDS: According to the World Labor Organization, the unemployment rate of HIV-infected persons is more than 3 times the average unemployment rate of the country, that is, unemployment rate = average unemployment rate of the country or region × (≥3). In the estimation, the unemployment rate of HIV-infected persons / AIDS patients is set to 5 times the average unemployment rate of my country. If HIV infection is caused by sexual transmission and the infection age is 44 years old, the unemployment rate in the effective working age stage is 4.1% × 5 = 20.5%;

[0184] Step C23-3: When calculating the present value of lifetime labor income of the infected person at the age of 44 after HIV infection caused by sexual transmission in step C23-2, according to the 2020 edition of the Pharmacoeconomic Evaluation Guidelines, the discount rate is 5%, and the present value of labor income in each year is discounted and converted into the present value of RMB in 2020. The base year used can be adjusted according to actual conditions;

[0185] Step C23-4: In the process of calculating the present value of labor income, the growth of gross domestic product is taken into account. In this calculation, the average annual growth rate of per capita GDP of 8.1% in Yunnan Province is used to correct the present value of each year's income. In actual calculation, the per capita GDP growth rate can be adjusted according to actual conditions;

[0186] Step C23-5: Use the income distribution coefficients of different age groups to weight the GDP per capita of each age group;

[0187] Step C23-6, subtract the present value of the labor income of a normal person from the present value of the labor income of an HIV-infected person / AIDS patient infected by sexual transmission, to obtain the indirect economic loss of an HIV-infected person infected by sexual transmission at the age of 44;

[0188] Step D comprises the following steps:

[0189] Step D1: Explain the results of the AIDS burden calculation, including: (1) Compare the differences in the AIDS burden at different times, in different regions, and under different demographic characteristics (STDs, age, and transmission routes), implement hierarchical management of regions facing the AIDS burden, and identify the population facing a higher burden of disease; (2) Compare the composition of the AIDS burden, determine the distribution of the disease burden caused by death and the disease burden caused by disability, and clarify the main prevention and control areas in different periods and regions;

[0190] Step D2: Explain the results of the AIDS health utility and quality-adjusted life years calculations, including: (1) The closer the health utility value is to 1, the better the health status, such as complete health in terms of physiology, psychology, and social adaptation; (2) Comparison of health utility values ​​under different AIDS prevention and control strategies as evidence for selecting the "best" prevention and control strategy; (3) Quality-adjusted life years are the outcome indicator of health-utility analysis in health economics evaluation and are the gold standard in health economics evaluation. By conducting cost-utility analysis, they provide evidence support for the priority selection of AIDS prevention and control strategies.

[0191] Step D3: Explain the results of the calculation of the economic burden of AIDS, including: (1) The total economic burden of AIDS is calculated by adding the direct economic burden and the indirect economic burden; (2) The economic burden of AIDS can be used as an estimate of the economic losses avoided by the implementation of AIDS prevention and control measures. The return on investment (ROI) is calculated by using the ratio of the total avoided economic losses to the total investment. ROI represents the economic benefit value obtained for every 1 yuan of investment, thereby quantifying the effect of the evaluated AIDS prevention and control measures; (3) The total economic burden of AIDS can be used as an outcome indicator of cost-effectiveness analysis in health economic evaluation. By conducting cost-effectiveness analysis, it provides evidence support for the priority selection of AIDS prevention and control strategies;

[0192] Step D4: Based on the above explanation, a comprehensive evaluation of regional AIDS prevention and control efficiency is formed, including a macro-level prediction of prevention and control efficiency development based on AIDS disease burden and economic burden, and a micro-level prediction of prevention and control efficiency development based on health utility.

[0193] The present invention is further explained below through application examples:

[0194] With the promotion and improvement of the effectiveness of antiviral treatment, AIDS tends to be a chronic infectious disease and will face treatment and health management throughout the life cycle. A single change in incidence, prevalence or mortality rate is difficult to reflect the efficiency of AIDS prevention and control. Therefore, taking Honghe Prefecture, Yunnan Province as an example, the disease burden caused by AIDS in the area from 2010 to 2020 was calculated, and the quality-adjusted life year DALY was used as the disease burden measurement indicator. The quality-adjusted life year DALY consists of two parts: the year of life lost due to premature death YLL and the year of healthy life lost due to disability YLD, that is: DALY = YLL + YLD. Using the DALY calculation Excel template designed by WHO, in the "DALY Parameters" part of the table, according to the latest version of the pharmacoeconomic evaluation guidelines, the "Discount rate" was changed to 0.05, and the other parameters were not adjusted; taking the HIV / AIDS patients aged 45-49 in the area in 2020 as an example, in the table "A.YLL In the "template" part, input the corresponding age population of 417469, the number of deaths of 19, and the average age of death of 47.74, and obtain 644.26 person-years of life lost due to premature death; the indirect method is used to obtain the YLD of healthy life lost due to disability, that is, the YLL obtained by measurement (644.26) is divided by the YLD / YLL ratio of GBD in China in 2020 (16.95), and the YLD of healthy life lost due to disability is estimated to be 38.01 person-years. The YLL of life lost due to premature death and the YLD of healthy life lost due to disability obtained by the indirect method are added together to obtain 682.27 person-years of quality-adjusted life years (DALY); finally, the total DALY of Honghe Prefecture from 2010 to 2020 is 74555.07 person-years; at the same time, compared with the DALY of 2010, the DALY of Honghe Prefecture is 74555.07 person-years. Compared with ALY, it increased by 5640.29 person-years in 2020, showing an overall trend of first increasing and then decreasing. It can be seen that under the implementation of the "China's 12th Five-Year Action Plan to Contain AIDS" and the People's War on AIDS in Yunnan Province, and driven by measures to achieve the three 90% prevention and control goals, the intensity of testing and treatment coverage have been continuously expanded. The number of surviving HIV / AIDS patients in Honghe Prefecture has continued to increase, and the disease burden has decreased, showing that the prevention and control efficiency of prevention and control measures has been improved from a macro-policy level; the years of life lost due to premature death (YLL) were 69113.56 person-years, accounting for 92.70%, and the years of healthy life lost due to disability (YLD) were 5441.51 person-years, accounting for 7.30%, indicating that AIDS-related deaths in Honghe Prefecture are still the main part of the AIDS disease burden, and the disease burden in the region is still at a high level.

[0195] Health-related quality of life (QALY) is a measurement indicator of comprehensive health status at the individual level. The EQ-5D-5L scale and SF-6D scale were used to measure a total of 1797 HIV-infected and AIDS patients in five prefectures and cities in Yunnan Province. First, the SF-12 scale and EQ-5D-5L scale were used to conduct a field survey. The SF-6D score calculated using the above technology was 0.772±0.137, the median score was 0.762, the interquartile range was 0.241, and the score range was 0.374-1.000; the EQ-5D-5L score was 0.896±0.150, the median score was 0.942, the interquartile range was 0.115, and the score range was -0.391-1.000. Through the analysis of measurement scores, it was found that the impact of "stigma", social support, anxiety and depression are influencing factors of disease burden at the individual level. At the same time, a comparison of the health utilities of infected persons and patients in five prefectures and cities in Yunnan Province found that the prevention and control efficiency of prevention and control models in different regions can be reflected from the individual's health utility level. The individual health utility level shows that Kunming, Honghe and Yuxi have superior prevention and control efficiency. At the same time, the health utility values ​​obtained by measurement were successfully applied to the evaluation report of the four rounds of the People's War on AIDS in Yunnan Province.

[0196] To calculate the economic burden, it is necessary to measure the direct economic burden and the indirect economic burden. From the perspective of policymakers, the implementation of the Prevention of Mother-to-Child Transmission of HIV (PMTCT) project in Yunnan Province from 2006 to 2015 was taken as an example. By comparing the mother-to-child transmission rate before and after the implementation of PMTCT, the total number of HIV infection cases avoided was estimated. The direct cost mainly avoids the cost of lifelong treatment for infants infected with HIV, including ART costs, regular follow-up and testing costs, and opportunistic infection treatment costs. The indirect cost includes the loss of productivity due to HIV infection, which is estimated by calculating the years of incapacity to work due to HIV infection in infants and considering the income differences of different age groups. Assumptions: The working age range of individuals in society is 18 to 60 years old; the life expectancy of children infected with HIV: 28.79 years old; the life expectancy of normal children: 60 years old; the unemployment rate faced by children infected with HIV in adulthood is 20.5%; the per capita GDP of Yunnan Province: US$4,222.66; the annual productivity growth rate: 8.5%; the medical expenses during childhood multiplied by the adjustment factor of 1.75. First, calculate the working years of HIV-infected people and normal people. The effective working years of normal children are: 60 years - 18 years = 42 years. The effective working years of HIV-infected children are: 28.79 years - 18 years = 10.79 years. Use the formula of the human capital method to calculate the total income of normal people in the working age group (18 to 60 years old) and the total income of HIV-infected children (18 to 28.79 years old), and finally calculate the income difference between normal children and HIV-infected children in the working years. Through the above technical calculations, the implementation of the PMTCT project has saved about US$500 million in direct medical expenses and about US$3.9 billion in indirect economic costs (productivity losses). On average, for every case of HIV infection in an infant avoided, the direct medical expenses saved are US$179,444, and the indirect economic benefits are US$1,433,310. The annual return on investment is greater than 45, and the total ROI for ten years is 88.37, showing an overall upward trend. The results of the study were included in the Yunnan Province Report on Eliminating Mother-to-Child Transmission of HIV, which showed the effectiveness of prevention and control of mother-to-child transmission of HIV in Yunnan Province over the past decade from the perspective of economic burden.

[0197] In AIDS prevention and control, DALY and QALY are important indicators for evaluating the effectiveness of health interventions. DALY helps quantify the impact of AIDS and its complications on patients' quality of life and the reduction of disease burden, while QALY combines the quantity and quality of life to measure the effects of different interventions on improving the quality of life. Together, these two indicators provide a comprehensive perspective for evaluating the effectiveness of prevention and control strategies. The prediction of economic burden involves the direct costs (such as treatment, testing and intervention costs) and indirect costs (such as productivity losses and) of AIDS prevention and control measures. Through the analysis of economic burden, the cost-effectiveness of prevention and control measures can be evaluated, and the impact of different strategies on total costs can be predicted to help determine the most effective resource allocation plan.

[0198] This model can effectively measure the effectiveness of prevention and control measures in reducing disease burden and improving quality of life, and form a comprehensive evaluation of regional AIDS prevention and control efficiency, including macro-prevention efficiency development forecasts based on AIDS disease burden and economic burden, and micro-individual-level prevention and control efficiency development forecasts based on health utility, revealing the long-term economic benefits of prevention and control measures and strategies for optimizing resource allocation. Continuously optimizing prevention and control strategies and resource allocation can improve prevention and control efficiency, reduce economic burden, and thus more effectively control the spread and impact of AIDS.

Claims

1. A method for constructing a regional AIDS prevention and control efficiency development prediction model, characterized in that The following steps are involved: Step A: Obtain AIDS disability-adjusted life years through AIDS disease burden measurement; Step B: Obtain AIDS quality-adjusted life years through AIDS health utility measurement; Step C: Obtain the direct and indirect economic burdens caused by AIDS through the calculation of the economic burden of AIDS; Step D: Through multi-dimensional measurement and integration, a regional AIDS prevention and control efficiency development prediction model is formed.

2. The method for constructing a regional AIDS prevention and control efficiency development prediction model according to claim 1, characterized in that: The step A comprises the following steps: Step A1: Obtain AIDS case data and death data of the population in the target area and divide them into the following age groups: under 1 year old, 1-4 years old, 5-9 years old, 10-14 years old, 15-19 years old, 80-84 years old, and over 85 years old; Step A2: Calculate the average age of death and average age of onset for each age group. The average age of death for each age group = the sum of the ages of the number of deaths in each age group / the number of deaths; the average age of onset for each age group = the sum of the ages of onset of patients in each age group / the number of patients, where the age of onset is the age at which AIDS is diagnosed; Step A3: Use the disease burden calculation Excel template published by the World Health Organization and do the following: Step A31: According to the latest version of the pharmacoeconomic evaluation guidelines, the discount rate of the quality-adjusted life year (DALY) part in the step A3 template is set to 0.05, and the other parameters remain unchanged; Step A32: In the A.YLL section of the template in step A3, input the population, number of deaths, and average age of death of the corresponding age group to obtain the YLL of life lost due to premature death of each age group, the total YLL of life lost due to premature death, and the YLL rate; where YLL rate = YLL / corresponding population × 100,000 / 100,000, which is used to reflect the proportion of life lost due to disease relative to the total population; YLL of life lost due to premature death is obtained by the following calculation: Taking into account the disability weight and time discount, the calculation formula of YLL is: In the formula, D is the disability weight, which is 1, where 0 indicates health and 1 indicates death; k is the age weight adjustment coefficient, which is 1; C is the continuity adjustment coefficient, which is 0.1658; e is the base of the natural logarithm, which is 2.71828; β is the age weight coefficient, which is 0.04; r is the discount rate, which is 0.05 according to the latest version of the pharmacoeconomic evaluation guidelines; L indicates the duration of disability or the time lost due to premature death; α is the age of death; where L is calculated using the standard life expectancy years lost method; Step A33: For the B.YLD portion of the template in step A3, calculate YLD using the following method: Method 1: In the B.YLD section of the step A3 template, enter the population, number of cases, average age of onset, average course of disease, and disability weight of the corresponding age group to obtain the YLD of healthy life lost due to disability in each age group, the total YLD of healthy life lost due to disability, and the YLD rate. Among them, the YLD rate = YLD / corresponding population × 100,000 / 100,000, which is used to reflect the proportion of disability years lost due to disease or health conditions to the total number of years for a specific population or the total population, as follows: Considering the disability weight and time discount, the calculation formula of YLD is: Wherein, D is the disability weight, which is 0.231; k is the age weight adjustment coefficient, which is 1; C is the continuous adjustment coefficient, which is 0.1658; e is the base of the natural logarithm, which is 2.71828; β is the age weight coefficient, which is 0.04; r is the discount rate, which is 0.05 according to the 2020 Pharmacoeconomic Evaluation Guidelines; L is the course of disability, which is 1; α is the actual age of onset of the patient; Method 2: Indirect estimation using the following formula from the Global Burden of Disease (GBD) study: YLD 目标(i，j) =YLL 目标(i，j) / YLL 参照(i，j) ×YLD 参照(i，j) Where: YLD 目标(i，j) YLL is the indirect estimate of the number of healthy life years lost due to disability in the target area. 目标(i，j) Years of life lost due to premature deaths in target areas, YLL 参照(i，j) Years of life lost due to premature death in the reference area of ​​the GBD study, YLD 参照(i，j) The years of healthy life lost due to disability in the reference area of ​​the GBD study; Step A34: The DALYs=YLL+YLD part in the template of step A3 is used to generate the quality-adjusted life years DALY for the corresponding age group and the total quality-adjusted life years DALY, among which the years of healthy life lost due to disability YLD is obtained by the indirect method of step A33.

3. The method for constructing a regional AIDS prevention and control efficiency development prediction model according to claim 1, characterized in that: The step B comprises the following steps: Step B1, download and obtain the EQ-5D-3L or EQ-5D-5L scale from the official website. The SF-6D scale is directly converted to the SF-6D scale or the SF-12 scale; Step B2: Conduct an on-site questionnaire survey on the subjects using the EQ-5D-3L / EQ-5D-5L or SF-6D scale to obtain the corresponding scale measurement scores; Step B3, calculating the scale measurement score of step B2 to obtain a health utility score; The health utility score in step B4 and step B3 is the health utility value. The expected life expectancy is multiplied by the health utility value to obtain the quality-adjusted life year (QALY).

4. The method for constructing a regional AIDS prevention and control efficiency development prediction model according to claim 3, characterized in that: The step B3 comprises the following steps: Step B31, using the EQ-5D-3L scale, converting the measurement scores according to the EQ-5D-3L utility scoring system for the Chinese population; Step B32, using the EQ-5D-5L scale, converting the measurement scores according to the EQ-5D-5L utility scoring system for the Chinese population; Step B33: Calculate the health utility score using the health utility scoring system of Brazier scholars based on the British population.

5. The method for constructing a regional AIDS prevention and control efficiency development prediction model according to claim 1, characterized in that: The step C comprises the following steps: Step C1: Calculate the direct economic burden of AIDS by multiplying the average cost of different types of AIDS prevention and treatment services by the number of times the corresponding AIDS prevention and treatment services are used to obtain the average treatment cost. The direct economic burden is calculated according to the product of the average treatment cost and the incidence or prevalence of the disease using the following formula: In the formula, P is the unit price of each AIDS prevention and treatment service, and n is the number of times; The direct economic burden calculation specifically includes the following steps: Step C11: Calculate the direct economic burden of HIV infection. The direct economic burden of AIDS is defined as the lifelong antiviral treatment costs of HIV or AIDS, which is calculated by adding the lifelong antiviral treatment costs, routine follow-up testing costs, adverse reaction treatment costs, and opportunistic infection prevention and treatment costs; Step C12: Collect the above costs by conducting special surveys or literature research, including antiviral treatment costs, routine testing and follow-up costs, adverse reaction treatment costs, and opportunistic infection prevention costs. Add the above costs to obtain the direct economic burden estimate. When calculating in this step, choose the social prevention perspective, that is, calculate based on the social prevention perspective; Step C13: If the infection occurred during infancy, the direct costs during childhood should be corrected to 1.75:1 with the direct costs for adults; Step C2: Calculate the indirect economic burden using the human capital approach, which includes the following steps: Step C21: Calculate the indirect economic losses of HIV-infected persons due to mother-to-child transmission. The indirect economic burden caused by HIV infection in an infant is calculated according to the following formula: E=E Normal -AND HIV In the formula, Y=18 means that the age is 18 years old. The starting year of the calculation is set as 2015. The present value of labor income from 2015 to Y is calculated. GDP (Y 2015 ) represents the per capita GDP of Yunnan Province in 2015. The year substituted into the formula can be updated and adjusted according to the specific calculation year. HIV represents the present value of labor income of HIV / AIDS patients, E Normal represents the present value of a normal person’s labor income, C income represents the income distribution coefficient, C discount represents the discount rate; the specific calculation steps are as follows: C21-1. When using the formula of C21 to calculate, it is assumed that the effective working time of a normal person is between 18 and 60 years old. The potential loss of effective working time is: 60-average infection age; C21-2. Assuming that the life expectancy of children infected with HIV is 28.79 years, the effective working time of HIV-infected children due to mother-to-child transmission at birth is calculated to be: 28.79-18 = 10.79 years, and the potential loss of effective working time is: 60-28.79 = 31.27 years; C21-3. When using the formula of C21 for calculation, HIV / AIDS patients have labor force loss and unemployment due to illness. Therefore, it is necessary to use the unemployment rate to weight the labor force value in order to estimate the loss of labor force value caused by HIV infection or AIDS. According to the World Labor Organization, the unemployment rate of HIV-infected people is more than 3 times the average unemployment rate of the country, that is, unemployment rate = average unemployment rate of the country or region × (≥3). In the estimation, the unemployment rate of HIV / AIDS patients is set to 5 times the average unemployment rate of my country. If HIV infection occurs during infancy due to mother-to-child transmission, the unemployment rate of the child when he grows up to the effective working age is: 4.1% × 5 = 20.5%; C21-4. When calculating the present value of the lifelong labor income of the infant infected with HIV due to mother-to-child transmission in step C21-3, according to the 2020 edition of the Guidelines for Pharmacoeconomic Evaluation, the discount rate is 5%, and the present value of labor income in each year is discounted and converted into the present value of RMB in 2015. The base year used can be adjusted according to actual conditions; C21-5. In the process of calculating the present value of labor income, the growth of gross domestic product is taken into account. The average annual growth rate of per capita GDP of 8.5% in Yunnan Province is used to correct the present value of each year's income. In actual calculation, the per capita GDP growth rate can be adjusted according to actual conditions; C21-6. Use the income distribution coefficient to weight the GDP per capita of each age group; C21-7. Subtract the present value of labor income E of normal children of each age group after they grow up to effective working age from the present value of labor income of HIV-infected children at effective working age to obtain the indirect economic burden of HIV infection in infants; Step C22: Calculate the indirect economic loss of HIV-infected persons due to intravenous drug use. The indirect economic burden caused by HIV infection in one person due to intravenous drug use is calculated according to the following formula: E=E Normal -AND HIV In the formula, Y represents the estimated year, 2020 is set as the starting year, and the present value of labor income from year Y to 2020 is estimated. The year substituted into the formula can be updated and adjusted according to the specific calculation year; E HIV E represents the present value of labor income of HIV-infected / AIDS patients; normal represents the present value of a normal person’s labor income; C income represents the income distribution coefficient, C discount represents the discount rate; the specific calculation steps are as follows: Step C22-1, when using the formula of C22 for calculation, it is first assumed that the effective working time of a normal person is 18-60 years old, and the average age of HIV infection caused by intravenous drug use is assumed to be 38 years old. The average age is replaced and adjusted according to the actual monitoring situation. It is assumed that the life expectancy of adult HIV-infected people is 75.1 years old. The expected age can be adjusted according to the actual situation. The potential loss of effective working time is: 60-average infection age. If HIV is infected by intravenous drug use at the age of 38, the effective working time is: 60-38=22 years; Step C22-2, HIV-infected / AIDS patients have labor force loss and unemployment due to illness. In the calculation process, the unemployment rate needs to be used to weight the labor force value to estimate the loss of labor force value caused by HIV infection or AIDS: First, according to the World Labor Organization's estimate, the unemployment rate of HIV-infected people is more than 3 times the average unemployment rate of the country, that is, unemployment rate = average unemployment rate of the country or region × (≥3). In the estimation, the unemployment rate of HIV-infected / AIDS patients is set to 5 times the average unemployment rate of my country. Therefore, if HIV is infected through intravenous injection due to drug abuse and the infected age is 38 years old, the unemployment rate in the effective working age stage is 4.1% × 5 = 20.5%; Step C22-3: When calculating the present value of lifetime labor income of the infected person infected with HIV through intravenous drug abuse at the age of 38 in step C22-2, according to the 2020 edition of the Pharmacoeconomic Evaluation Guidelines, the discount rate is 5%, and the present value of labor income in each year is discounted and converted into the present value of RMB in 2020. The base year used can be adjusted according to actual conditions; Step C22-4: In the process of calculating the present value of labor income, the growth of gross domestic product is taken into account. The average annual growth rate of per capita GDP of 8.1% in Yunnan Province is used to correct the present value of each year's income. In actual calculation, the per capita GDP growth rate can be adjusted according to actual conditions; Step C22-5: Use the income distribution coefficients of different age groups to weight the GDP per capita of each age group; Step C22-6, subtract the present value of the labor income of a normal person from the present value of the labor income of a person infected with HIV / AIDS due to intravenous drug use, to obtain the indirect economic loss of a person infected with HIV due to intravenous drug use at the age of 38; Step C23: Calculate the indirect economic losses of HIV-infected persons through sexual transmission. The indirect economic burden caused by HIV infection in one person through sexual transmission is calculated according to the following formula: E=E Normal -AND HIV In the formula, Y represents the estimated year, 2020 is set as the starting year, and the present value of labor income from year Y to 2020 is estimated; the year substituted into the formula is updated and adjusted according to the specific calculation year; E HIV E represents the present value of labor income of HIV-infected / AIDS patients; normal represents the present value of a normal person’s labor income; C income represents the income distribution coefficient, C discount represents the discount rate; the specific calculation steps are as follows: Step C23-1. When calculating with the formula of step C23, it is first assumed that the effective working time of a normal person is 18-60 years old, and the average age of HIV infection due to sexual transmission is assumed to be 44 years old. The average age is replaced and adjusted according to the actual monitoring situation. It is assumed that the life expectancy of adult HIV-infected people is 75.1 years old. The expected age is adjusted according to the actual situation. The potential loss of effective working time is: 60-average infection age; if HIV is infected due to sexual transmission at the age of 44, the effective working time is: 60-44=16 years; Step C23-2, HIV-infected persons / AIDS patients suffer from labor force loss and unemployment due to illness. In the calculation process, the unemployment rate is used to weight the labor force value to estimate the loss of labor force value caused by HIV infection or AIDS: According to the World Labor Organization, the unemployment rate of HIV-infected persons is more than 3 times the average unemployment rate of the country, that is, unemployment rate = average unemployment rate of the country or region × (≥3). In the estimation, the unemployment rate of HIV-infected persons / AIDS patients is set to 5 times the average unemployment rate of my country. If HIV infection is caused by sexual transmission and the infection age is 44 years old, the unemployment rate in the effective working age stage is 4.1% × 5 = 20.5%; Step C23-3: When calculating the present value of lifetime labor income of the infected person at the age of 44 after HIV infection caused by sexual transmission in step C23-2, according to the 2020 edition of the Pharmacoeconomic Evaluation Guidelines, the discount rate is 5%, and the present value of labor income in each year is discounted and converted into the present value of RMB in 2020. The base year used can be adjusted according to actual conditions; Step C23-4: In the process of calculating the present value of labor income, the growth of gross domestic product is taken into account. In this calculation, the average annual growth rate of per capita GDP of 8.1% in Yunnan Province is used to correct the present value of each year's income. In actual calculation, the per capita GDP growth rate can be adjusted according to actual conditions; Step C23-5: Use the income distribution coefficients of different age groups to weight the GDP per capita of each age group; Step C23-6: Subtract the present value of the labor income of a normal person from the present value of the labor income of a person infected with HIV / AIDS due to sexual transmission, and obtain the indirect economic loss of a person infected with HIV due to sexual transmission at the age of 44.

6. The method for constructing a regional AIDS prevention and control efficiency development prediction model according to claim 1, characterized in that: The step D comprises the following steps: Step D1: Explain the results of the AIDS burden calculation, including: (1) Compare the differences in the AIDS burden at different times, in different regions, and under different demographic characteristics such as sexually transmitted diseases, age, and transmission routes, implement hierarchical management of regions facing the AIDS burden, and identify the population facing the highest disease burden; (2) Compare the composition of the AIDS burden, determine the distribution of the disease burden caused by death and the disease burden caused by disability, and clarify the main prevention and control areas in different periods and regions; Step D2: Explain the results of the AIDS health utility and quality-adjusted life years calculations, including: (1) the closer the health utility value is to 1, the better the health status; (2) compare the health utility values ​​under different AIDS prevention and control strategies; (3) Quality-adjusted life years are the outcome indicators of health-utility analysis in health economics evaluation. By conducting cost-utility analysis, it provides evidence support for the priority selection of AIDS prevention and control strategies; Step D3: Explain the results of the calculation of the economic burden of AIDS, including: (1) The total economic burden of AIDS is calculated by adding the direct economic burden and the indirect economic burden; (2) The economic burden of AIDS can be used as an estimate of the economic losses avoided by the implementation of AIDS prevention and control measures. The return on investment (ROI) is calculated by taking the ratio of the total avoided economic losses to the total investment. ROI represents the economic benefit value obtained for every 1 yuan of investment, thereby quantifying the effect of the evaluated AIDS prevention and control measures; (3) The total economic burden of AIDS can be used as an outcome indicator of cost-effectiveness analysis in health economic evaluation. By conducting cost-effectiveness analysis, it provides evidence support for the priority selection of AIDS prevention and control strategies; Step D4: Based on the above explanation, a comprehensive evaluation of regional AIDS prevention and control efficiency is formed, including a macro-level prediction of prevention and control efficiency development based on AIDS disease burden and economic burden, and a micro-level prediction of prevention and control efficiency development based on health utility.

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