Hall Jennifer L, Katz Ben Z
Children's Memorial Hospital, Division of Infectious Diseases and Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60614, USA.
J Pediatr. 2005 Dec;147(6):807-11. doi: 10.1016/j.jpeds.2005.06.031.
To calculate the costs of influenza hospitalization at a tertiary care children's hospital as the basis of a cost-benefit analysis of the new influenza vaccine recommendation for children age 6 to 23 months.
We reviewed the medical records of all patients admitted to Children's Memorial Hospital (CMH) in 2002 diagnosed with influenza. Total hospital costs were obtained from the Business Development Office.
Thirty-five charts were analyzed. Both of the 2 patients requiring mechanical ventilation and 4 of 6 patients admitted to the intensive care unit had high-risk underlying medical conditions. Nine children were age 6 to 23 months; 4 of these 9 had no preexisting medical conditions. Had all 18 high-risk children over age 6 months been protected from influenza, approximately $350,000 in hospital charges could have been saved.
Preventing the additional 4 hospitalizations in the otherwise low-risk children age 6 to 23 months for whom vaccine is currently recommended would have cost approximately $281,000 ($46/child) more than the hospital charges saved. When all children age 6 to 23 months are considered, influenza vaccination is less costly than other prophylactic measures. Addition of indirect costs, deaths, outpatient costs, and the cost of secondary cases would favor the cost:benefit ratio for influenza vaccination of all children age 6 to 23 months.
计算一家三级护理儿童医院的流感住院费用,以此作为对6至23个月大儿童新流感疫苗推荐进行成本效益分析的基础。
我们回顾了2002年入住儿童纪念医院(CMH)且被诊断为流感的所有患者的病历。医院总成本从业务发展办公室获取。
分析了35份病历。2名需要机械通气的患者以及6名入住重症监护病房的患者中有4名存在高危基础疾病。9名儿童年龄在6至23个月;这9名儿童中有4名没有基础疾病。如果所有18名6个月以上的高危儿童都能预防流感,那么大约可以节省35万美元的住院费用。
对于目前推荐接种疫苗的6至23个月原本低风险儿童而言,预防额外的4例住院所需的费用比节省的住院费用大约多28.1万美元(每名儿童46美元)。当考虑所有6至23个月的儿童时,流感疫苗接种的成本低于其他预防措施。加上间接成本、死亡、门诊成本以及二代病例的成本,将有利于所有6至23个月儿童流感疫苗接种的成本效益比。