Hak E, Meijboom M J, Buskens E
University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, P.O. Box 85500, 3508 GA Utrecht, The Netherlands.
Vaccine. 2006 Nov 10;24(44-46):6756-60. doi: 10.1016/j.vaccine.2006.05.065. Epub 2006 Jun 9.
To optimally develop or adjust national contingency plans to respond to the next influenza pandemic, we developed a decision type model and estimated the total health burden and direct medical costs during the next possible influenza pandemic in the Netherlands on the basis of health care burden during a regular epidemic. Using an arithmetic decision tree-type model we took into account population characteristics, varying influenza attack rates, health care consumption according to the Dutch health care model and all-cause mortality. Actual direct medical cost estimates were based on the Dutch guidelines for pharmaco-economic evaluation. In the base-case scenario with no preventive measure available and an average influenza attack rate of 30%, 4,958,188 influenza infections, 1,552,687 GP consultations, 83,515 hospitalizations and 173,396 deaths will take place in The Netherlands. The burden is highest in adults aged 20 to 64 years. If minimizing the total mortality and sustaining highest net economic returns is the objective, this group needs to be targeted in interventions.
为了优化制定或调整国家应对下一次流感大流行的应急预案，我们开发了一种决策类型模型，并根据常规疫情期间的医疗负担，估算了荷兰下一次可能发生的流感大流行期间的总体健康负担和直接医疗费用。我们使用算术决策树类型模型，考虑了人口特征、不同的流感感染率、根据荷兰医疗模式的医疗消费以及全因死亡率。实际直接医疗费用估算是基于荷兰药物经济学评估指南。在没有预防措施且平均流感感染率为30%的基础情景下，荷兰将发生4958188例流感感染、1552687次全科医生诊疗、83515次住院治疗和173396例死亡。负担在20至64岁的成年人中最高。如果目标是将总死亡率降至最低并维持最高的净经济回报，那么干预措施应针对这一年龄组。
