Szucs T, Behrens M, Volmer T
Abteilung für Medizinökonomie Universitätshospital Rämistrasse 100 CH-8000 Zürich.
Med Klin (Munich). 2001 Feb 15;96(2):63-70. doi: 10.1007/pl00002180.
Influenza is often seen as an unproblematic and self-limiting disease despite putting a high burden on patients as well as being of high socio-economic relevance to societies. This analysis aims to visualize that influenza deserves a rise in attention especially because of its socio-economic relevance, based on a transparent methodology. This analysis investigates the costs caused by influenza in Germany in 1996. The analysis is based on a costs model that takes in official aggregated statistical and publicly available data. A top-down approach based on the ICD-9 Code 487 is used. The costs of influenza in 1996 came to nearly DM 5 billion. Only a small proportion of this was due to direct treatment costs (DM 0.6 billion). The direct costs are made up of 304 million DM (52.8%) for ambulatory care, 214 million DM (37.1%) for prescription-only and OTC medication, and 58 million DM (10.1%) for inpatient treatment including rehabilitation measures. The bulk of the indirect costs, some DM 4.4 billion (99.5%), was due to unfitness for work, whereas only about 21 million DM (0.5%) was accounted for by occupational disability and deaths. On the basis of an estimated 4 million cases of influenza in 1996 (no epidemics), the costs work out at about 1,237 DM per patient per year. In the event of an epidemic, the German economy would be faced with correspondingly higher costs of over DM 10.5 billion. Effective prevention and treatment strategies such as better pre-season vaccination rates, early diagnosis and effective antiviral therapy can help to reduce this financial burden.
尽管流感给患者带来了沉重负担,且对社会具有高度的社会经济相关性,但它常常被视为一种不成问题的自限性疾病。本分析旨在基于一种透明的方法,表明流感因其社会经济相关性而值得更多关注。本分析调查了1996年德国流感造成的成本。该分析基于一个成本模型,该模型采用官方汇总统计数据和公开可用数据。采用了基于国际疾病分类第九版(ICD - 9)编码487的自上而下方法。1996年流感的成本接近50亿德国马克。其中只有一小部分是直接治疗成本(6亿德国马克)。直接成本包括门诊护理3.04亿德国马克(52.8%)、仅处方和非处方药2.14亿德国马克(37.1%)以及包括康复措施在内的住院治疗5800万德国马克(10.1%)。间接成本的大部分,约44亿德国马克(99.5%),是由于无法工作造成的,而职业残疾和死亡仅占约2100万德国马克(0.5%)。根据1996年估计的400万例流感病例(无疫情),每位患者每年的成本约为1237德国马克。如果发生疫情,德国经济将面临相应更高的成本,超过105亿德国马克。有效的预防和治疗策略,如提高季前疫苗接种率*、早期诊断和有效的抗病毒治疗,有助于减轻这一经济负担。
*注:原文“better pre-season vaccination rates”直译为“更好的季前疫苗接种率”,这里意译为“提高季前疫苗接种率”使表达更符合中文习惯。