Université Pierre et Marie Curie-Paris, France.
PLoS Negl Trop Dis. 2011 Jun;5(6):e1197. doi: 10.1371/journal.pntd.0001197. Epub 2011 Jun 14.
This study was conducted to assess the impact of chikungunya on health costs during the epidemic that occurred on La Réunion in 2005-2006.
METHODOLOGY/PRINCIPAL FINDINGS: From data collected from health agencies, the additional costs incurred by chikungunya in terms of consultations, drug consumption and absence from work were determined by a comparison with the expected costs outside the epidemic period. The cost of hospitalization was estimated from data provided by the national hospitalization database for short-term care by considering all hospital stays in which the ICD-10 code A92.0 appeared. A cost-of-illness study was conducted from the perspective of the third-party payer. Direct medical costs per outpatient and inpatient case were evaluated. The costs were estimated in Euros at 2006 values. Additional reimbursements for consultations with general practitioners and drugs were estimated as € 12.4 million (range: € 7.7 million-€ 17.1 million) and € 5 million (€ 1.9 million-€ 8.1 million), respectively, while the cost of hospitalization for chikungunya was estimated to be € 8.5 million (€ 5.8 million-€ 8.7 million). Productivity costs were estimated as € 17.4 million (€ 6 million-€ 28.9 million). The medical cost of the chikungunya epidemic was estimated as € 43.9 million, 60% due to direct medical costs and 40% to indirect costs (€ 26.5 million and € 17.4 million, respectively). The direct medical cost was assessed as € 90 for each outpatient and € 2,000 for each inpatient.
CONCLUSIONS/SIGNIFICANCE: The medical management of chikungunya during the epidemic on La Réunion Island was associated with an important economic burden. The estimated cost of the reported disease can be used to evaluate the cost/efficacy and cost/benefit ratios for prevention and control programmes of emerging arboviruses.
本研究旨在评估 2005-2006 年留尼汪岛登革热疫情期间基孔肯雅热对卫生费用的影响。
方法/主要发现:通过与流行期外的预期费用进行比较,从卫生机构收集的数据中确定了基孔肯雅热在就诊、药物使用和旷工方面的额外费用。通过考虑 ICD-10 代码 A92.0 出现的所有住院治疗,从第三方支付者的角度对住院费用进行了估算。采用疾病成本研究方法。评估了每例门诊和住院患者的直接医疗费用。以 2006 年的价值计算,费用以欧元表示。估算了全科医生就诊和药物的额外报销费用分别为 1240 万欧元(770 万欧元至 1710 万欧元)和 500 万欧元(190 万欧元至 810 万欧元),而基孔肯雅热的住院费用估计为 850 万欧元(580 万欧元至 870 万欧元)。生产力成本估计为 1740 万欧元(600 万欧元至 2890 万欧元)。基孔肯雅热疫情的医疗费用估计为 4390 万欧元,其中 60%为直接医疗费用,40%为间接费用(分别为 2650 万欧元和 1740 万欧元)。每位门诊患者的直接医疗费用估计为 90 欧元,每位住院患者为 2000 欧元。
结论/意义:留尼汪岛登革热疫情期间的基孔肯雅热医疗管理带来了巨大的经济负担。所报告疾病的估计费用可用于评估新兴虫媒病毒防控计划的成本效益和成本效益比。