Keren Ron, Zaoutis Theoklis E, Saddlemire Stephanie, Luan Xian Qun, Coffin Susan E
Children's Hospital of Philadelphia, 3535 Market St, Room 1524, Philadelphia, PA 19104, USA.
Pediatrics. 2006 Nov;118(5):e1321-7. doi: 10.1542/peds.2006-0598.
Our goal was to determine the cost of influenza-related hospitalization in children with community-acquired laboratory-confirmed influenza and to identify predictors of high hospitalization costs.
This was a retrospective cohort study of patients 21 years and younger hospitalized at a children's hospital with community-acquired laboratory-confirmed influenza during 4 consecutive influenza seasons (2000-2004). The main outcome measure was the direct medical cost of influenza-related hospitalizations, including the cost of diagnostics, therapeutics, room, and physician services.
Electronic billing data were retrievable for 727 (98%) of 745 patients hospitalized for community-acquired laboratory-confirmed influenza during the study period. A total of 478 (66%) children were in a high-risk group for whom the Advisory Committee on Immunization Practices recommended influenza vaccine (patients with Advisory Committee on Immunization Practices-designated chronic medical conditions or aged 6-23 months). The mean total cost of hospitalization for influenza-related illness was 13,159 dollars (39,792 dollars for patients admitted to an ICU; 7030 dollars for patients cared for exclusively on the wards). High-risk patients had higher mean total costs (15,269 dollars) than low-risk patients (9107 dollars). Cardiac, metabolic, and neurologic/neuromuscular diseases and age of 18 to 21 years were independently associated with the highest hospitalization costs (>15th percentile).
The cost of influenza-related hospitalizations in children may be considerably higher than previously estimated. The presence of certain Advisory Committee on Immunization Practices-designated chronic medical conditions is associated with higher influenza-related hospitalization costs. Successfully immunizing patients with these conditions has the potential for significant cost savings.
我们的目标是确定社区获得性实验室确诊流感患儿的流感相关住院费用，并找出高住院费用的预测因素。
这是一项回顾性队列研究，研究对象为在一家儿童医院住院的21岁及以下患者，这些患者在连续4个流感季节（2000 - 2004年）患有社区获得性实验室确诊流感。主要结局指标是流感相关住院的直接医疗费用，包括诊断、治疗、病房和医生服务费用。
在研究期间，745例因社区获得性实验室确诊流感住院的患者中，有727例（98%）的电子计费数据可检索。共有478例（66%）儿童属于免疫实践咨询委员会建议接种流感疫苗的高危组（患有免疫实践咨询委员会指定的慢性疾病或年龄在6 - 23个月的患者）。流感相关疾病的平均住院总费用为13,159美元（入住重症监护病房的患者为39,792美元；仅在病房接受治疗的患者为7030美元）。高危患者的平均总费用（15,269美元）高于低危患者（9107美元）。心脏、代谢、神经/神经肌肉疾病以及18至21岁的年龄与最高住院费用（>第15百分位数）独立相关。
儿童流感相关住院费用可能比先前估计的要高得多。免疫实践咨询委员会指定的某些慢性疾病与较高的流感相关住院费用相关。成功为患有这些疾病的患者接种疫苗有可能大幅节省费用。
