Rheingans Richard D, Constenla Dagna, Antil Lynn, Innis Bruce L, Breuer Thomas
Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia 30322, USA.
Rev Panam Salud Publica. 2007 Apr;21(4):192-204. doi: 10.1590/s1020-49892007000300002.
To estimate the health and economic burden of rotavirus gastroenteritis in hospital and outpatient settings in eight Latin American and Caribbean countries (Argentina, Brazil, Chile, Dominican Republic, Honduras, Mexico, Panama, and Venezuela).
An economic model was constructed using epidemiological data from published articles, national health administration studies, and country-specific cost estimates. For each of the eight countries, the model estimated the rotavirus outcomes for the 2003 birth cohort during the first five years of life. The main outcome measures included health care costs, transportation costs, lost wages, and disease burden expressed in disability-adjusted life years. Estimates were expressed in 2003 US dollars. All future costs and disability-adjusted life year estimates were discounted at a rate of 3%. Sensitivity analyses evaluated the impact of specific variables on the medical cost of treating rotavirus.
For every 1,000 children born during 2003 in the eight Latin American and Caribbean countries studied here, we estimated that rotavirus gastroenteritis would result in an average of 246 outpatient visits, 24 hospitalizations, 0.6 deaths, and 7,971 US dollars in direct medical costs during their first five years of life. The incidence of rotavirus-associated outpatient visits and the cost of outpatient visits were predicted to have the largest impact on the total medical cost per child.
Rotavirus gastroenteritis is likely to result in substantial disease and economic burden to health systems in Latin American and Caribbean countries, and the foreseeable burden should be an important consideration in evaluating the cost-effectiveness of vaccination.
评估拉丁美洲和加勒比地区八个国家（阿根廷、巴西、智利、多米尼加共和国、洪都拉斯、墨西哥、巴拿马和委内瑞拉）医院和门诊环境中轮状病毒肠胃炎的健康和经济负担。
利用已发表文章的流行病学数据、国家卫生管理研究以及特定国家的成本估算构建经济模型。对于这八个国家中的每一个，该模型估算了2003年出生队列在生命最初五年的轮状病毒感染结果。主要结局指标包括医疗保健成本、交通成本、工资损失以及以伤残调整生命年表示的疾病负担。估算以2003年美元表示。所有未来成本和伤残调整生命年估算均按3%的贴现率进行贴现。敏感性分析评估了特定变量对治疗轮状病毒医疗成本的影响。
对于在此研究的拉丁美洲和加勒比地区八个国家中2003年出生的每1000名儿童，我们估计轮状病毒肠胃炎在其生命的前五年中将导致平均246次门诊就诊、24次住院、0.6例死亡以及7971美元的直接医疗成本。轮状病毒相关门诊就诊的发生率和门诊就诊成本预计对每个儿童的总医疗成本影响最大。
轮状病毒肠胃炎可能给拉丁美洲和加勒比地区国家的卫生系统带来巨大疾病和经济负担，在评估疫苗接种的成本效益时，可预见的负担应是一个重要考虑因素。
