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[医疗机构人员流感疫苗接种活动的效果及经济影响评估]

[Assessment of efficacy and economic impact of an influenza vaccination campaign in the personnel of a health care setting].

作者信息

Cella Maria Teresa, Corona G, Tuccillo Elvira, Franco G

机构信息

Cattedra e Scuola di Specializzazione in Medicina del Lavoro, Università di Modena e Reggio Emilia--Struttura Complessa di Medicina del Lavoro, Servizio di Sorveglianza Sanitaria, Azienda Ospedaliero-Universitaria, Modena.

出版信息

Med Lav. 2005 Nov-Dec;96(6):483-9.

Abstract

INTRODUCTION

Although vaccination against influenza is a well-established practice among the elderly in rest homes, in community-dwelling elderly people and in persons with underlying medical conditions associated with a high risk of complications, vaccination of workers is not always considered cost-effective, even though influenza is high on the list of diseases of public health importance. The aim of this study was to evaluate the efficacy and the cost-benefit ratio of an influenza vaccination campaign in health care workers (HCW) of a teaching hospital.

METHODS

A group of 423 HCW vaccinated against influenza during the 2002-2003 winter season was compared with a group of subjects not vaccinated, matched for sex and working area. The following outcomes were considered: (i) prevalence of influenza-like illness (ILI); (ii) days of absence from work due to ILL The cost-benefit ratio was calculated with a model using the following indices. indirect benefits (IB), indirect non medical costs (IC) and direct costs (DC).

RESULTS

The prevalence of ILI in the non vaccinated group (102 cases out of 423 subjects, 24%) was significantly increased (p < 0.001) compared with vaccinated subjects (64 cases out of 423, 15%). Working days lost for ILI were 516 in the non-vaccinated group versus 315 reported in the vaccinated group. Economic impact evaluation showed a cost of Euro 35,786.88 in vaccinees and of Euro 57,759.52 in the non-vaccinees. The resulting IB was Euro 21,078.64. The DC and IC for vaccination were Euro 2,463.29 and Euro 2,172.53 respectively. The overall cost-benefit ratio (IB/DC+IC) was 4.5.

DISCUSSION

The study shows that the influenza vaccination campaign was effective in preventing the influenza syndrome in HCW The economic impact assessment shows a cost-saving with an important cost-benefit ratio. This study suggests that a continuous effort should be recommended to increase the compliance of HCW with vaccination practice both to reduce their chance of becoming infected and for the economic benefits for healthy working adults.

摘要

引言

尽管在养老院的老年人、社区居住的老年人以及有并发症高风险基础疾病的人群中,接种流感疫苗是一种既定做法,但对于医护人员的疫苗接种,即使流感在具有公共卫生重要性的疾病清单上名列前茅,人们也并不总是认为其具有成本效益。本研究的目的是评估一家教学医院医护人员流感疫苗接种活动的效果和成本效益比。

方法

将2002 - 2003年冬季接种流感疫苗的423名医护人员与未接种疫苗的一组人员进行比较,后者在性别和工作区域方面进行了匹配。考虑了以下结果:(i)流感样疾病(ILI)的患病率;(ii)因ILI缺勤的天数。使用以下指标的模型计算成本效益比。间接效益(IB)、间接非医疗成本(IC)和直接成本(DC)。

结果

未接种疫苗组的ILI患病率(423名受试者中有102例,24%)与接种疫苗的受试者(423名中有64例,15%)相比显著增加(p < 0.001)。未接种疫苗组因ILI损失的工作日为516天,而接种疫苗组报告为315天。经济影响评估显示,接种疫苗者的成本为35,786.88欧元,未接种者为57,759.52欧元。由此产生的IB为21,078.64欧元。疫苗接种的DC和IC分别为2,463.29欧元和2,172.53欧元。总体成本效益比(IB/DC + IC)为4.5。

讨论

该研究表明,流感疫苗接种活动在预防医护人员的流感综合征方面是有效的。经济影响评估显示有成本节约且成本效益比很高。本研究表明,应持续努力提高医护人员对疫苗接种的依从性,以降低他们感染的几率,并为健康的在职成年人带来经济效益。

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