Hassan Fauziya, Lewis Toby C, Davis Matthew M, Gebremariam Achamyeleh, Dombkowski Kevin
Division of Sleep Medicine, Child Health Evaluation and Research Unit, University of Michigan, Ann Arbor, Michigan 48109-5456, USA.
Am J Prev Med. 2009 Apr;36(4):292-6. doi: 10.1016/j.amepre.2008.11.016. Epub 2009 Feb 7.
Longstanding recommendations for influenza vaccines among children were augmented by the Advisory Committee on Immunization Practices (ACIP) in 2002 and again in 2008 to encourage vaccination among healthy children aged 6 months-18 years. Little is known about the hospital costs and length of stay among high-risk and otherwise healthy children for the groups affected by the 2002 and 2008 recommendations of the ACIP. The burden of influenza may vary between children with high-risk medical conditions and those who are otherwise healthy. The objective of the current study was to characterize the national burden of influenza hospitalizations and to evaluate how hospital costs and length of stay varied among children diagnosed with influenza.
A retrospective analysis of influenza hospitalizations was performed in 2006 using the Healthcare Cost and Utilization Project Kids' Inpatient Database, a nationally representative database of hospital discharge records for children from January to December 2003. Children aged <or=18 years with the primary or secondary diagnosis of influenza were classified into three groups based on ACIP recommendations (0-5 months, 6-23 months, 24 months-18 years) and further subdivided by diagnostic codes (asthma, other chronic diseases, without chronic conditions). The outcome measures were aggregate national and mean hospital costs and mean length of stay.
In 2003, aggregate national costs for children with a diagnosis of influenza were $76.5 million, 55% of which was among the group for whom an influenza vaccine was recommended or encouraged in 2003. These costs corresponded to 77,264 inpatient days for 27,363 influenza hospitalizations (2.8 days average length of stay). Mean costs were higher for children with influenza and chronic diseases ($7774) compared to those for children with asthma ($3469) and children without chronic conditions ($2785). Sub-analyses regarding recently expanded national recommendations revealed that 41% of all hospitalizations with a diagnosis of influenza were among otherwise healthy children aged 24 months-18 years.
In 2003, over half of the influenza hospitalizations and costs associated with influenza occurred among children for whom an influenza vaccination was recommended. The frequency of influenza hospitalizations among children aged 24 months-18 years supports recent expansion of the ACIP influenza vaccination recommendations.
2002年免疫实践咨询委员会（ACIP）扩大了对儿童流感疫苗接种的长期建议，并于2008年再次扩大，以鼓励6个月至18岁的健康儿童接种疫苗。对于2002年和2008年ACIP建议所涉及群体中高危儿童和其他健康儿童的住院费用及住院时间，人们了解甚少。流感负担在患有高危疾病的儿童和其他健康儿童之间可能有所不同。本研究的目的是描述全国流感住院负担，并评估确诊流感的儿童的住院费用和住院时间如何变化。
利用医疗保健成本和利用项目儿童住院数据库对2006年流感住院情况进行回顾性分析，该数据库是2003年1月至12月全国具有代表性的儿童出院记录数据库。将年龄小于或等于18岁且主要或次要诊断为流感的儿童根据ACIP建议分为三组（0至5个月、6至23个月、24个月至18岁），并根据诊断代码进一步细分（哮喘、其他慢性病、无慢性病）。结果指标为全国总费用和平均住院费用以及平均住院时间。
2003年，诊断为流感的儿童全国总费用为7650万美元，其中55%发生在2003年建议或鼓励接种流感疫苗的群体中。这些费用对应于27363例流感住院的77264个住院日（平均住院时间2.8天）。与患有哮喘的儿童（3469美元）和无慢性病的儿童（2785美元）相比，患有流感和慢性病的儿童平均费用更高（7774美元）。关于最近扩大的全国建议的亚分析显示，所有诊断为流感的住院病例中有41%发生在24个月至18岁的健康儿童中。
2003年，超过一半的流感住院病例以及与流感相关的费用发生在建议接种流感疫苗的儿童中。24个月至18岁儿童流感住院的频率支持了ACIP最近扩大流感疫苗接种建议的做法。
