Molinari Noelle-Angelique M, Ortega-Sanchez Ismael R, Messonnier Mark L, Thompson William W, Wortley Pascale M, Weintraub Eric, Bridges Carolyn B
Immunization Service Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Mail-Stop E-88, Atlanta, GA 30333, USA.
Vaccine. 2007 Jun 28;25(27):5086-96. doi: 10.1016/j.vaccine.2007.03.046. Epub 2007 Apr 20.
Despite preventive efforts, influenza epidemics are responsible for substantial morbidity and mortality every year in the United States (US). Vaccination strategies to reduce disease burden have been implemented. However, no previous studies have systematically estimated the annual economic burden of influenza epidemics, an estimate necessary to guide policy makers effectively.
We estimate age- and risk-specific disease burden, and medical and indirect costs attributable to annual influenza epidemics in the United States.
Using a probabilistic model and publicly available epidemiological data we estimated the number of influenza-attributable cases leading to outpatient visits, hospitalization, and mortality, as well as time lost from work absenteeism or premature death. With data from health insurance claims and projections of either earnings or statistical life values, we then estimated healthcare resource utilization associated with influenza cases as were their medical and productivity (indirect) costs in $2003.
Based on 2003 US population, we estimated that annual influenza epidemics resulted in an average of 610,660 life-years lost (undiscounted), 3.1 million hospitalized days, and 31.4 million outpatient visits. Direct medical costs averaged $10.4 billion (95% confidence interval [C.I.], $4.1, $22.2) annually. Projected lost earnings due to illness and loss of life amounted to $16.3 billion (C.I., $8.7, $31.0) annually. The total economic burden of annual influenza epidemics using projected statistical life values amounted to $87.1 billion (C.I., $47.2, $149.5).
These results highlight the enormous annual burden of influenza in the US. While hospitalization costs are important contributors, lost productivity from missed work days and lost lives comprise the bulk of the economic burden of influenza.
尽管采取了预防措施，但在美国，流感疫情每年仍导致大量发病和死亡。已实施了减轻疾病负担的疫苗接种策略。然而，以前没有研究系统地估计流感疫情的年度经济负担，而这一估计对于有效指导政策制定者是必要的。
我们估计美国每年流感疫情按年龄和风险划分的疾病负担以及医疗和间接成本。
使用概率模型和公开可得的流行病学数据，我们估计了导致门诊就诊、住院和死亡的流感所致病例数，以及因旷工或过早死亡而损失的时间。利用来自医疗保险理赔的数据以及收入或统计生命价值的预测，我们随后估计了与流感病例相关的医疗资源利用情况以及它们在2003年的医疗和生产力（间接）成本。
基于2003年美国人口，我们估计每年流感疫情平均导致610,660个生命年损失（未贴现）、310万住院日和3140万门诊就诊。每年直接医疗成本平均为104亿美元（95%置信区间[C.I.]，41亿美元，222亿美元）。因疾病和生命损失预计每年损失收入达163亿美元（C.I.，87亿美元，310亿美元）。使用预测的统计生命价值，每年流感疫情的总经济负担达871亿美元（C.I.，472亿美元，1495亿美元）。
这些结果凸显了美国每年流感负担的巨大。虽然住院成本是重要因素，但因旷工导致的生产力损失和生命损失构成了流感经济负担的大部分。
