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一项关于美国儿童中按照《国际疾病分类(临床修订版第9版)》诊断的流感及相关并发症的发病率、医疗资源利用情况和成本的回顾性队列研究。

A Retrospective Cohort Study of the Incidence, Health Care Resource Utilization and Costs of International Classification of Diseases, Clinical Modification, 9th Revision Diagnosed Influenza and Related Complications in US Children.

作者信息

Buck Philip O, Smith David M, Shenolikar Rahul, Irwin Debra E

机构信息

From the *GSK, Philadelphia, Pennsylvania; †Truven Health Analytics, an IBM Company, Bethesda, Maryland; ‡GSK, Research Triangle Park, North Carolina; and §Truven Health Analytics, an IBM Company, Durham, North Carolina.

出版信息

Pediatr Infect Dis J. 2017 Dec;36(12):1129-1140. doi: 10.1097/INF.0000000000001693.

Abstract

BACKGROUND

There is a paucity of data on the clinical and economic impact of seasonal influenza in children. This study estimated the incidence of diagnosed influenza and related complications and associated health care resource utilization and costs in US children.

METHODS

Children ≥6 months and <18 years old diagnosed with influenza using International Classification of Diseases, Clinical Modification, 9th revision codes and enrolled in a health plan during at least one influenza season between 2010 and 2014 were matched to similar patients without diagnosed influenza (GSK study identifier: HO-15-15728). Outcomes included incidence of influenza and complications, health care resource utilization frequency and health care costs during 21 days of follow-up. Adjusted costs were estimated using generalized linear models.

RESULTS

Incidence (per 1000) of influenza was 20.3 (commercially insured) and 32.6 (Medicaid), with the highest incidence among 6-35 months old (Commercial: 26.8; Medicaid: 47.9). Approximately 12%-17% of influenza patients experienced complications, with the 6-35 months group having the highest percentage (25%-30%). The 6-35-month-old influenza patients with complications had the highest proportion with hospitalizations (5%-6%) and emergency room visits (Commercial: 19%; Medicaid: 36%). Influenza patients with (vs. without) complications had greater adjusted mean influenza-specific costs (Commercial: $1161 vs. $337; Medicaid: $1199 vs. $354; P<0.05), and influenza cases (vs. controls) had greater adjusted mean all-cause costs (Commercial: $688 vs. $470; Medicaid: $818 vs. $453; P < 0.05).

CONCLUSIONS

Pediatric patients with influenza incurred higher health care costs compared with matched controls, and influenza-specific costs were greater among those with complications.

摘要

背景

关于季节性流感对儿童的临床和经济影响的数据较少。本研究估计了美国儿童确诊流感及相关并发症的发病率,以及相关医疗资源利用情况和成本。

方法

使用国际疾病分类临床修订第9版编码诊断为流感且在2010年至2014年期间至少一个流感季节参加了健康计划的6个月及以上、18岁以下儿童,与未确诊流感的类似患者进行匹配(葛兰素史克研究标识符:HO-15-15728)。结局包括流感及并发症的发病率、随访21天期间的医疗资源利用频率和医疗成本。使用广义线性模型估计调整后的成本。

结果

流感发病率(每1000人)在商业保险人群中为20.3,在医疗补助人群中为32.6,6至35个月大的儿童发病率最高(商业保险:26.

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