Unit of PharmacoTherapy, Epidemiology & Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands.
Department of Epidemiology, University Medical Center Groningen, Groningen, The Netherlands.
Influenza Other Respir Viruses. 2018 Jul;12(4):457-464. doi: 10.1111/irv.12558. Epub 2018 May 24.
Despite the clinical evidence, influenza vaccination coverage of healthcare workers remains low. To assess the health economic value of implementing an influenza immunization program among healthcare workers (HCW) in University Medical Centers (UMCs) in the Netherlands, a cost-benefit model was developed using a societal perspective.
METHODS/PATIENTS: The model was based on a trial performed among all UMCs in the Netherlands that included both hospital staff and patients admitted to the pediatrics and internal medicine departments. The model structure and parameters estimates were based on the trial and complemented with literature research, and the impact of uncertainty explored with sensitivity analyses.
In a base-case scenario without vaccine coverage, influenza-related annual costs were estimated at € 410 815 for an average UMC with 8000 HCWs and an average occupancy during the influenza period of 6000 hospitalized patients. Of these costs, 82% attributed to the HCWs and 18% were patient-related. With a vaccination coverage of 15.47%, the societal program's savings were € 2861 which corresponds to a saving of € 270.53 per extended hospitalization. Univariate sensitivity analyses show that the results are most sensitive to changes in the model parameters vaccine effectiveness in reducing influenza-like illness (ILI) and the vaccination-related costs.
In addition to the decreased burden of patient morbidity among hospitalized patients, the effects of the hospital immunization program slightly outweigh the economic investments. These outcomes may support healthcare policymakers' recommendations about the influenza vaccination program for healthcare workers.
尽管有临床证据，但医护人员的流感疫苗接种率仍然很低。为了评估在荷兰大学医学中心（UMC）的医护人员（HCW）中实施流感免疫计划的健康经济效益，采用社会视角开发了一种成本效益模型。
方法/患者：该模型基于在荷兰所有 UMC 中进行的一项试验，该试验包括医院工作人员和被收入儿科和内科病房的患者。模型结构和参数估计基于该试验，并辅以文献研究，同时通过敏感性分析探讨了不确定性的影响。
在没有疫苗接种覆盖率的基本情况下，对于一个拥有 8000 名 HCW 和平均流感期间住院患者 6000 人的平均 UMC，估计与流感相关的年度成本为 410815 欧元。这些成本中，82%归因于 HCW，18%与患者有关。在接种率为 15.47%的情况下，社会计划的节省额为 2861 欧元，这相当于每延长一次住院节省 270.53 欧元。单变量敏感性分析表明，结果对模型参数的变化最为敏感，包括疫苗在减轻流感样疾病（ILI）方面的有效性和与疫苗接种相关的成本。
除了住院患者发病率负担的减轻外，医院免疫计划的效果略超过经济投资。这些结果可能支持医疗保健政策制定者关于医护人员流感疫苗接种计划的建议。
