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日本流感样疾病管理的特点。

The characteristics of influenza-like illness management in Japan.

机构信息

Department of Paediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.

AMR Clinical Reference Center, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.

出版信息

BMC Public Health. 2020 Apr 28;20(1):568. doi: 10.1186/s12889-020-08603-x.

Abstract

BACKGROUND

This study aimed to make a quantitative assessment of the management of influenza-like illnesses (ILI) in Japanese healthcare settings.

METHODS

We analysed participants' healthcare-seeking behaviour and physicians' practice in January 2019 using an online survey of 200 households in Japan. Quality of life score, quality-adjusted life years lost, the duration of symptoms, and the duration of absence from work were compared between the influenza ILI group and the non-influenza ILI group with one-to-one propensity score matching. Missing data were imputed using multiple imputation.

RESULTS

In total, 261 of the 600 (43.5%) participants had at least one episode of influenza-like illness during January 2019. Of these, 194 (75.5%) visited healthcare facilities, 167 (86.1%) within 2 days of onset of symptoms. A total of 169 out of 191 (88.5%) received a rapid influenza diagnostic test and 101 were diagnosed with influenza, of whom 95.0% were treated with antivirals. The median quality-adjusted life-years (QALYs) lost was 0.0055 (interquartile range, IQR 0.0040-0.0072) and median absence from work for a single episode of influenza-like illness was 2 days (IQR 1-5 days). Albeit QALYs lost per episode was not different between two groups, the influenza ILI group showed longer duration of absence from work (5 days, IQR 4-6 days) than the non-influenza ILI group (2 days, IQR 1-3 days).

CONCLUSIONS

In Japan, most people with influenza-like illnesses visit healthcare facilities soon after symptoms first occur and receive a diagnostic test. Those with influenza are usually treated with antivirals. Absence from work was longer for influenza than other similar illnesses.

摘要

背景

本研究旨在对日本医疗机构中流感样疾病(ILI)的管理进行定量评估。

方法

我们于 2019 年 1 月使用在线调查的方式对日本 200 户家庭的参与者的就医行为和医生的治疗方案进行了分析。采用 1:1 倾向评分匹配法比较流感 ILI 组和非流感 ILI 组的生活质量评分、质量调整生命年损失、症状持续时间和缺勤时间。使用多重插补法对缺失数据进行了填补。

结果

2019 年 1 月,600 名参与者中共有 261 名(43.5%)至少发生过一次流感样疾病。其中,194 名(75.5%)前往医疗机构就诊,167 名(86.1%)在症状出现后 2 天内就诊。191 名就诊者中有 169 名(88.5%)接受了快速流感诊断检测,101 名被诊断为流感,其中 95.0%接受了抗病毒治疗。中位质量调整生命年(QALYs)损失为 0.0055(四分位间距 0.0040-0.0072),单次流感样疾病缺勤的中位时间为 2 天(四分位间距 1-5 天)。尽管两组间每例疾病损失的 QALYs 无差异,但流感 ILI 组的缺勤时间(5 天,四分位间距 4-6 天)长于非流感 ILI 组(2 天,四分位间距 1-3 天)。

结论

在日本,大多数流感样疾病患者在症状首次出现后很快就会前往医疗机构就诊并接受诊断检测。患有流感的患者通常会接受抗病毒治疗。流感患者的缺勤时间长于其他类似疾病。

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