Department of Pediatrics, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
Vaccine. 2013 Aug 28;31(38):4164-71. doi: 10.1016/j.vaccine.2013.06.085. Epub 2013 Jul 8.
To determine the medical costs of laboratory-confirmed rotavirus hospitalizations and emergency department (ED) visits and estimate the economic impact of the rotavirus vaccine program.
During 4 rotavirus seasons (2006-2009), children <3 years of age hospitalized or seen in the ED with laboratory-confirmed rotavirus were identified through active population-based rotavirus surveillance in three US counties. Medical costs were obtained from hospital and physician billing data, and factors associated with increased costs were examined. Annual national costs were estimated using rotavirus hospitalization and ED visit rates and medical costs for rotavirus hospitalizations and ED visits from our surveillance program for pre- (2006-2007) and post-vaccine (2008-2009) time periods.
Pre-vaccine, for hospitalizations, the median medical cost per child was $3581, the rotavirus hospitalization rate was 22.1/10,000, with an estimated annual national cost of $91 million. Post-vaccine, the median medical cost was $4304, the hospitalization rate was 6.3/10,000 and the estimated annual national cost was $31 million. Increased costs were associated with study site, age <3 months, underlying medical conditions and an atypical acute gastroenteritis presentation. For ED visits, the pre-vaccine median medical cost per child was $574, the ED visit rate was 291/10,000 resulting in an estimated annual national cost of $192 million. Post-vaccine, the median medical cost was $794, the ED visit rate was 71/10,000 with an estimated annual national cost of $65 million.
After implementation of rotavirus immunization, the total annual medical costs decreased from $283 million to $96 million, an annual reduction of $187 million.
确定实验室确诊轮状病毒住院和急诊 (ED) 就诊的医疗费用，并估计轮状病毒疫苗计划的经济影响。
在 4 个轮状病毒季节（2006-2009 年）期间，通过美国三个县的主动人群轮状病毒监测，确定了 <3 岁住院或在 ED 就诊且实验室确诊为轮状病毒的儿童。从医院和医生计费数据中获得医疗费用，并检查与增加费用相关的因素。使用我们的监测计划为疫苗接种前（2006-2007 年）和疫苗接种后（2008-2009 年）时间段获得的轮状病毒住院和 ED 就诊率以及轮状病毒住院和 ED 就诊的医疗费用，估计全国年度费用。
疫苗接种前，每名儿童的住院中位医疗费用为 3581 美元，轮状病毒住院率为 22.1/10000，估计全国年度费用为 9100 万美元。疫苗接种后，中位医疗费用为 4304 美元，住院率为 6.3/10000，估计全国年度费用为 3100 万美元。增加的费用与研究地点、<3 个月大、基础医疗条件和非典型急性胃肠炎表现有关。对于 ED 就诊，疫苗接种前每名儿童的中位医疗费用为 574 美元，ED 就诊率为 291/10000，估计全国年度费用为 1.92 亿美元。疫苗接种后，中位医疗费用为 794 美元，ED 就诊率为 71/10000，估计全国年度费用为 6500 万美元。
轮状病毒免疫接种实施后，总年度医疗费用从 2.83 亿美元降至 9600 万美元，每年减少 1.87 亿美元。
