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大流行性流感对英国的全经济范围影响:一项可计算一般均衡建模实验。

The economy-wide impact of pandemic influenza on the UK: a computable general equilibrium modelling experiment.

作者信息

Smith Richard D, Keogh-Brown Marcus R, Barnett Tony, Tait Joyce

机构信息

Health Policy Unit, Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London WC1E 7HT.

出版信息

BMJ. 2009 Nov 19;339:b4571. doi: 10.1136/bmj.b4571.

Abstract

OBJECTIVES

To estimate the potential economic impact of pandemic influenza, associated behavioural responses, school closures, and vaccination on the United Kingdom.

DESIGN

A computable general equilibrium model of the UK economy was specified for various combinations of mortality and morbidity from pandemic influenza, vaccine efficacy, school closures, and prophylactic absenteeism using published data.

SETTING

The 2004 UK economy (the most up to date available with suitable economic data).

MAIN OUTCOME MEASURES

The economic impact of various scenarios with different pandemic severity, vaccination, school closure, and prophylactic absenteeism specified in terms of gross domestic product, output from different economic sectors, and equivalent variation.

RESULTS

The costs related to illness alone ranged between 0.5% and 1.0% of gross domestic product ( pound8.4bn to pound16.8bn) for low fatality scenarios, 3.3% and 4.3% ( pound55.5bn to pound72.3bn) for high fatality scenarios, and larger still for an extreme pandemic. School closure increases the economic impact, particularly for mild pandemics. If widespread behavioural change takes place and there is large scale prophylactic absence from work, the economic impact would be notably increased with few health benefits. Vaccination with a pre-pandemic vaccine could save 0.13% to 2.3% of gross domestic product ( pound2.2bn to pound38.6bn); a single dose of a matched vaccine could save 0.3% to 4.3% ( pound5.0bn to pound72.3bn); and two doses of a matched vaccine could limit the overall economic impact to about 1% of gross domestic product for all disease scenarios.

CONCLUSION

Balancing school closure against "business as usual" and obtaining sufficient stocks of effective vaccine are more important factors in determining the economic impact of an influenza pandemic than is the disease itself. Prophylactic absence from work in response to fear of infection can add considerably to the economic impact.

摘要

目的

评估甲型流感大流行、相关行为反应、学校停课及疫苗接种对英国可能产生的经济影响。

设计

利用已发表数据,针对甲型流感的死亡率和发病率、疫苗效力、学校停课及预防性缺勤的各种组合,构建了一个英国经济的可计算一般均衡模型。

背景

2004年英国经济(可获取的最新且具备合适经济数据的情况)。

主要观察指标

根据国内生产总值、不同经济部门产出及等价变化,确定不同大流行严重程度、疫苗接种、学校停课及预防性缺勤等各种情景的经济影响。

结果

对于低致死率情景,仅疾病相关成本就占国内生产总值的0.5%至1.0%(84亿英镑至168亿英镑);高致死率情景下为3.3%至4.3%(555亿英镑至723亿英镑),极端大流行时成本更高。学校停课会增加经济影响,尤其是对轻度大流行而言。如果出现广泛的行为变化且大量人员预防性缺勤,经济影响将显著增加,而健康益处却很少。大流行前疫苗接种可节省国内生产总值的0.13%至2.3%(22亿英镑至386亿英镑);一剂匹配疫苗可节省0.3%至4.3%(50亿英镑至723亿英镑);两剂匹配疫苗可将所有疾病情景下的总体经济影响限制在国内生产总值的约1%。

结论

在决定流感大流行的经济影响方面,权衡学校停课与“照常营业”以及获得足够的有效疫苗库存比疾病本身更为重要。因恐惧感染而预防性缺勤会大幅增加经济影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0563/4787477/6595ee91737b/smir708164.f1_default.jpg

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