中国苏州 5 岁以下儿童流感疾病的经济负担：2011/12 至 2016/17 流感季节成本调查报告。
Economic burden of influenza illness among children under 5 years in Suzhou, China: Report from the cost surveys during 2011/12 to 2016/17 influenza seasons.
机构信息
Department of Epidemiology, School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China; Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China.
Suzhou Center for Disease Prevention and Control, Suzhou, China.
出版信息
Vaccine. 2021 Feb 22;39(8):1303-1309. doi: 10.1016/j.vaccine.2020.12.075. Epub 2021 Jan 23.
BACKGROUND
Data are limited on the economic burden of seasonal influenza in China. We estimated the cost due to influenza illness among children < 5-year-old in Suzhou, China.
METHODS
This study adopted a societal perspective to estimate direct medical cost, direct non-medical cost, and indirect cost related to lost productivity. Data to calculate costs and rates of three influenza illness outcomes (non-medically attended, outpatient and hospitalization) were collected from prospective community-based cohort studies and hospital-based enhanced laboratory-confirmed influenza surveillance in Suzhou during the 2011/12 to 2016/17 influenza seasons. We used mean cost-per-episode, annual incidence rates of episodes of each outcome, and annual population size to estimate the total annual economic burden of influenza illnesses among children < 5-year-old for Suzhou. All costs were reported in 2017 U.S. dollars.
RESULTS
The mean cost-per-episode (standard deviation) was $9.92 (13.26) for non-medically attended influenza, $161.05 (176.98) for influenza outpatient illnesses, and $1425.95 (603.59) for influenza hospitalizations. By applying the annual incidence rates to the population size, we estimated an annual total of 4,919 episodes of non-medically attended influenza, 21,994 influenza outpatient, and 2,633 influenza hospitalization. Total annual economic burden of influenza to society among children < 5-year-old in Suzhou was $7.37 (95% confidence interval, 6.9-7.8) million, with estimated costs for non-medically attended influenza of $49,000 (46,000-52,000), influenza outpatients $3.5 (3.3-3.8) million, and influenza hospitalizations $3.8 (3.6-3.9) million. Among outpatients, the indirect cost was 36.3% ($1.3 million) of total economic burden, accounting for 21,994 days of lost productivity annually. Among inpatients, the indirect cost was 22.1% ($829,000), accounting for 18,431 days of lost productivity annually.
CONCLUSIONS
Our findings show that influenza in children < 5-year-oldcauses substantial societal economic burden in Suzhou, China. Assessing the potential economic benefit of increasing influenza vaccination coverage in this population is warranted.
背景
关于中国季节性流感的经济负担的数据有限。我们估算了在中国苏州，5 岁以下儿童因流感患病而导致的费用。
方法
本研究采用社会视角来估算直接医疗费用、直接非医疗费用和与生产力损失相关的间接费用。为了计算三种流感患病结果（未经医疗治疗、门诊和住院）的费用和发生率，我们从苏州 2011/12 至 2016/17 流感季节的基于社区的前瞻性队列研究和基于医院的增强型实验室确诊流感监测中收集数据。我们使用每例的平均费用、每种结果的年度发生率和年度人口规模来估算苏州 5 岁以下儿童的流感总年度经济负担。所有费用均以 2017 年美元报告。
结果
未经医疗治疗的流感的平均每例费用（标准差）为 9.92 美元（13.26），流感门诊的平均每例费用为 161.05 美元（176.98），流感住院的平均每例费用为 1425.95 美元（603.59）。通过将年度发生率应用于人口规模，我们估算了苏州每年有 4919 例未经医疗治疗的流感、21994 例流感门诊和 2633 例流感住院。苏州 5 岁以下儿童的流感总社会经济负担为 737 万美元（95%置信区间为 690-780 万美元），其中未经医疗治疗的流感费用为 49 万美元（460,000-520,000 美元），流感门诊费用为 350 万美元（330,000-380,000 美元），流感住院费用为 380 万美元（360,000-390,000 美元）。在门诊患者中，间接费用占总经济负担的 36.3%（130 万美元），占每年 21994 天的生产力损失。在住院患者中，间接费用占 22.1%（82.9 万美元），占每年 18431 天的生产力损失。
结论
我们的研究结果表明，儿童 5 岁以下流感在中国苏州造成了巨大的社会经济负担。评估增加该人群中流感疫苗接种覆盖率的潜在经济效益是合理的。
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