抄録
Background The cost of stroke in middle-aged and elderly workers has a large economic impact in Japan. Therefore, to detect individuals with risk factors for the stroke, including silent cerebral infarction (SCI) is crucial. The purpose of the present study is to propose an efficient screening system for detecting SCI in middle-aged and elderly Japanese employees, by using the cost-effectiveness analysis.
Methods The target population is 23 million full-time employees from 40 to 64 years old in Japan. The validity of the screening criteria to detect the SCI was estimated using the data that were collected from the brain check-up at Mominoki Hospital (Kochi, Japan). We defined “effect” as the number of individuals in whom SCI was detected by brain MRI and “HT” as a systolic BP≥140 mmHg or a diastolic BP≥90 mmHg. We evaluated the direct health care costs and estimated the cost per case detected.
Results The cost per case detected for the screening criteria of “age≥60 and HT” proved the best and it was estimated to be 56,000 yen. The results of sensitivity analysis suggested that the screening criteria of “age≥60” or “age≥45 and HT” was more robust and reliable than “age≥60 and HT”.
Conclusion The cost per case detected of this hypothetical screening system for detecting SCI does not appear to be very expensive compared to several other screening systems in Japan.
