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一家三级儿童专科医院的流感住院费用及其对6至23个月儿童普遍接种流感疫苗建议的成本效益分析的影响。

Cost of influenza hospitalization at a tertiary care children's hospital and its impact on the cost-benefit analysis of the recommendation for universal influenza immunization in children age 6 to 23 months.

作者信息

Hall Jennifer L, Katz Ben Z

机构信息

Children's Memorial Hospital, Division of Infectious Diseases and Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60614, USA.

出版信息

J Pediatr. 2005 Dec;147(6):807-11. doi: 10.1016/j.jpeds.2005.06.031.

Abstract

OBJECTIVE

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.

STUDY DESIGN

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

目的

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。

研究设计

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。

结果

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。

结论

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。

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