「臺北市學前兒童發展檢核表第二版」於兩種切截策略之施用成本

The Cost of the Two Cutoff Strategies of the “Taipei City Developmental Screening Checklist for Preschoolers, 2nd Version”

本研究之目的為探討「台北市學前兒童發展檢核表第二版」（簡稱Taipei II）兩個切截策略之成本。由文獻收集、訪談與專家會議整理主要篩選流程與相關花費，再由社會觀點分析直接成本與間接成本。根據Taipei II 切截策略之選擇率、發展篩選流程之複雜度與兒童年齡，共有8 個成本估算版本。Taipei II 切截策略A（不通過題數≥1 為疑似發展遲緩），每人每次之總成本為新台幣82.62－290.78 元，直接成本58.26 –231.82 元，間接成本28.36 – 58.96 元；於Taipei II 切截策略B（不通過題數≥2 或不通過星狀題數≥1 為疑似發展遲緩），則分別為70.15－246.24 元，45.53 – 189.75，24.62 – 56.49 元。從社會觀點看，切截策略B 之成本都低於切截策略A。根據本研究Taipei II 之成本計算結果，改為同時考慮B 策略在綜合效度指標及總預期效用值比A 策略來得好，於臨床使用Taipei II 切截策略B 較切截策略A 為合理。

The purpose of this study was to investigate the cost of two cutoff strategies of the Taipei City Developmental Screening Checklist for Preschoolers 2nd version (Taipei II). The flow charts and expenses of the screening process were collected by literature reviews, interview and experts meeting. Then the ingredient model was used to calculate the direct and indirect costs according to the components of the flow charts from the societal point of view. From the selection ratios of two cutoff strategies, complexity of the screening process, and children’s age, there were 8 versions used for cost calculation. For cutoff strategy A (failure number ≥1 being suspected developmental delay), the total cost, direct cost, and indirect cost were 82.62 – 290.78 NT dollars, 58.26 – 231.82 NT dollars, and 28.36 – 58.96 NT dollars for each screening per child respectively. For cutoff strategy B (failure number ≥2 or ≥1marked item failure being suspected developmental delay), those were 70.15 – 246.24 NT dollars, 45.53 – 189.75 NT dollars, and 24.62 – 56.49 NT dollars respectively. From the social point of view the cost of the cutoff strategy B was lower than that of the strategy A. Considering the cost of Taipei II, the strategy B is less costly than the strategy A in the widespread application.