Fendrick A Mark, Monto Arnold S, Nightengale Brian, Sarnes Matthew
Division of General Internal Medicine, Department of Internal Medicine, School of Medicine, University of Michigan, 300 N Ingalls Bldg, Room 7E06, Ann Arbor, MI 48109-0376, USA.
Arch Intern Med. 2003 Feb 24;163(4):487-94. doi: 10.1001/archinte.163.4.487.
Viral respiratory tract infection (VRTI) is the most common illness in humans. Despite the high incidence, the economic impact of non-influenza-related VRTI has not been rigorously explored. Our objectives were to obtain an updated incidence of non-influenza-related VRTI in the United States and to quantify the health care resource use (direct costs) and productivity losses (indirect costs) associated with these infections.
A nationwide telephone survey of US households (N = 4051) was conducted between November 3, 2000, and February 12, 2001 to obtain a representative estimate of the self-reported incidence of non-influenza-related VRTI and related treatment patterns. Direct treatment costs measured included outpatient clinician encounters, use of over-the-counter and prescription drugs, and associated infectious complications of non-influenza-related VRTI. Absenteeism estimates for infected individuals and parents of infected children were extrapolated from National Health Interview Survey data.
Of survey respondents, 72% reported a non-influenza-related VRTI within the past year. Respondents who experienced a self-reported non-influenza-related VRTI averaged 2.5 episodes annually. When these rates are extrapolated to the entire US population, approximately 500 million non-influenza-related VRTI episodes occur per year. Similarly, if the treatment patterns reported by the respondents are extended to the population, the total economic impact of non-influenza-related VRTI approaches $40 billion annually (direct costs, $17 billion per year; and indirect costs, $22.5 billion per year).
Largely because of the high attack rate, non-influenza-related VRTI imposes a greater economic burden than many other clinical conditions. The pending availability of effective antiviral therapies warrants increased attention be paid to this common and expensive illness.
病毒性呼吸道感染(VRTI)是人类最常见的疾病。尽管发病率很高,但与非流感相关的VRTI的经济影响尚未得到严格探究。我们的目标是获取美国非流感相关VRTI的最新发病率,并量化与这些感染相关的医疗资源使用(直接成本)和生产力损失(间接成本)。
在2000年11月3日至2001年2月12日期间对美国家庭进行了全国性电话调查(N = 4051),以获得自我报告的非流感相关VRTI发病率及相关治疗模式的代表性估计。所测量的直接治疗成本包括门诊医生诊疗、非处方和处方药的使用以及非流感相关VRTI的相关感染并发症。感染个体及其感染儿童的父母的缺勤估计数是根据国家健康访谈调查数据推断得出的。
在调查受访者中,72%报告在过去一年中患有非流感相关的VRTI。自我报告患有非流感相关VRTI的受访者平均每年发作2.5次。将这些发病率推算至整个美国人口时,每年约发生5亿次非流感相关的VRTI发作。同样,如果将受访者报告的治疗模式推广至整个人口,非流感相关VRTI的总经济影响每年接近400亿美元(直接成本每年170亿美元;间接成本每年225亿美元)。
主要由于高发病率,非流感相关的VRTI比许多其他临床病症造成的经济负担更大。即将可用的有效抗病毒疗法值得对这种常见且昂贵的疾病给予更多关注。