García-Basteiro Alberto L, Bosch Anna, Sicuri Elisa, Bayas José M, Trilla Antoni, Hayes Edward B
Preventive Medicine and Epidemiology Unit, Hospital Clínic, C/Villarroel 170, CP 08036 Barcelona, Spain.
BMC Res Notes. 2011 Oct 20;4:429. doi: 10.1186/1756-0500-4-429.
Rotavirus is the most common cause of severe gastroenteritis among young children in Spain and worldwide. We evaluated hospitalizations due to community and hospital-acquired rotavirus gastroenteritis (RVGE) and estimated related costs in children under 5 years old in Catalonia, Spain.
We analyzed hospital discharge data from the Catalan Health Services regarding hospital admissions coded as infectious gastroenteritis in children under 5 for the period 2003-2008. In order to estimate admission incidence, we used population estimates for each study year published by the Statistic Institut of Catalonia (Idescat). The costs associated with hospital admissions due to rotavirus diarrhea were estimated for the same years. A decision tree model was used to estimate the threshold cost of rotavirus vaccine to achieve cost savings from the healthcare system perspective in Catalonia. From 2003 through 2008, 10655 children under 5 years old were admitted with infectious gastroenteritis (IGE). Twenty-two percent of these admissions were coded as RVGE, yielding an estimated average annual incidence of 104 RVGE hospitalizations per 100000 children in Catalonia. Eighty seven percent of admissions for RVGE occurred during December through March. The mean hospital stay was 3.7 days, 0.6 days longer than for other IGE. An additional 892 cases of presumed nosocomial RVGE were detected, yielding an incidence of 2.5 cases per 1000 child admissions. Total rotavirus hospitalization costs due to community acquired RVGE for the years 2003 and 2008 were 431,593 and 809,224 €, respectively. According to the estimated incidence and hospitalization costs, immunization would result in health system cost savings if the cost of the vaccine was 1.93 € or less. At a vaccine cost of 187 € the incremental cost per hospitalization prevented is 195,388 € (CI 95% 159,300; 238,400).
The burden of hospitalizations attributable to rotavirus appeared to be lower in Catalonia than in other regions of Spain and Europe. The relatively low incidence of hospitalization due to rotavirus makes rotavirus vaccination less cost-effective in Catalonia than in other areas with higher rotavirus disease burden.
轮状病毒是西班牙及全球幼儿严重肠胃炎最常见的病因。我们评估了社区获得性和医院获得性轮状病毒肠胃炎（RVGE）导致的住院情况，并估算了西班牙加泰罗尼亚地区5岁以下儿童的相关费用。
我们分析了加泰罗尼亚卫生服务机构2003 - 2008年期间5岁以下儿童因感染性肠胃炎编码住院的出院数据。为估算住院发病率，我们使用了加泰罗尼亚统计研究所（Idescat）公布的各研究年份的人口估算数据。对同几年因轮状病毒腹泻导致的住院费用进行了估算。采用决策树模型估算轮状病毒疫苗的阈值成本，以便从加泰罗尼亚医疗系统的角度实现成本节约。2003年至2008年，10655名5岁以下儿童因感染性肠胃炎（IGE）住院。其中22%的住院病例被编码为RVGE，加泰罗尼亚地区每100000名儿童中RVGE住院的估计年均发病率为104例。87%的RVGE住院发生在12月至次年3月。平均住院天数为3.7天，比其他IGE长0.6天。另外检测到892例疑似医院获得性RVGE病例，发病率为每1000例儿童住院中有2.5例。2003年和2008年社区获得性RVGE导致的轮状病毒住院总费用分别为431,593欧元和809,224欧元。根据估算的发病率和住院费用，如果疫苗成本为1.93欧元或更低，免疫接种将为卫生系统节省成本。疫苗成本为187欧元时，预防每例住院的增量成本为195,388欧元（95%置信区间159,300；238,400）。
加泰罗尼亚地区轮状病毒导致的住院负担似乎低于西班牙和欧洲的其他地区。轮状病毒导致的住院发病率相对较低，使得加泰罗尼亚地区轮状病毒疫苗接种的成本效益低于其他轮状病毒疾病负担较高的地区。
