Hartwig Susanne, Uhari Matti, Renko Marjo, Bertet Perrine, Hemming Maria, Vesikari Timo
Epidemiology Department, Sanofi Pasteur MSD, Lyon, France.
BMC Health Serv Res. 2014 Dec 11;14:632. doi: 10.1186/s12913-014-0632-z.
Vaccination-impact studies of the live-attenuated pentavalent oral vaccine Rotateq® have demonstrated that the burden of rotavirus gastroenteritis has been reduced significantly after the introduction of RotaTeq® vaccination, but less is known about the benefit of this vaccination on hospital overcrowding.
As part of an observational surveillance conducted during the RV seasons 2000/2001 to 2011/2012, we analysed hospital discharge data collected retrospectively from two Finnish hospitals (Oulu and Tampere), concerning ICD 10 codes A00-09 (acute gastroenteritis, AGE) and A08.0 (rotaviral acute gastroenteritis RV AGE). We estimated the reduction in the number of beds occupied and analysed the bed occupancy rate, for RV AGE and all cause AGE, among 0-16 year-old children, before and after the implementation of the RV immunisation program.
The rate of bed days occupied for RV AGE was reduced by 86% (95% CI 66%-94%) in Tampere and 79% (95% CI 47%-92%) in Oulu after RV vaccination implementation. For all cause AGE, reduction was 50% (95% CI 29% to 65%) in Tampere and 70% (95% CI 58% to 79%) in Oulu. Results were similar among 0-2 year-old children. This effect was also observed on overcrowding in both hospitals, with a bed occupancy rate for all cause AGE >25% in only 1% of the time in Tampere and 9% in Oulu after the implementation of the immunisation program, compared to 13% and 48% in the pre-vaccination period respectively. After extrapolation to the whole country, the annual number of prevented hospitalizations for all cause AGE in the post-vaccination period in Finland was estimated at 1,646 and 2,303 admissions for 0-2 and 0-16 year-old children respectively.
This study demonstrated that universal RV vaccination is associated with a clear decrease in the number of bed days and occupancy rates for RV AGE and all cause AGE. Positive consequences include increase in quality of care and a better healthcare management during winter epidemics.
减毒活五价口服疫苗Rotateq®的疫苗接种影响研究表明，引入RotaTeq®疫苗接种后，轮状病毒肠胃炎的负担显著降低，但关于这种疫苗接种对医院过度拥挤状况的益处了解较少。
作为在2000/2001至2011/2012年轮状病毒流行季节进行的一项观察性监测的一部分，我们分析了从芬兰两家医院（奥卢和坦佩雷）回顾性收集的医院出院数据，涉及国际疾病分类第10版编码A00 - 09（急性肠胃炎，AGE）和A08.0（轮状病毒急性肠胃炎，RV AGE）。我们估计了0至16岁儿童在实施轮状病毒免疫计划前后，RV AGE和所有病因AGE的占用床位数减少情况，并分析了床位占用率。
在坦佩雷，实施轮状病毒疫苗接种后，RV AGE的床位占用天数率降低了86%（95%置信区间66% - 94%），在奥卢降低了79%（95%置信区间47% - 92%）。对于所有病因AGE，坦佩雷降低了50%（95%置信区间29%至65%），奥卢降低了70%（95%置信区间58%至79%）。在0至2岁儿童中结果相似。在两家医院的过度拥挤情况方面也观察到了这种效果，实施免疫计划后，所有病因AGE的床位占用率>25%的时间在坦佩雷仅为1%，在奥卢为9%，而接种疫苗前分别为13%和48%。推算至全国后，芬兰疫苗接种后0至2岁和0至16岁儿童因所有病因AGE每年预防的住院人数估计分别为1646例和2303例。
本研究表明，普遍接种轮状病毒疫苗与RV AGE和所有病因AGE的床位占用天数及占用率明显下降相关。积极影响包括护理质量提高以及冬季流行期间更好的医疗管理。
