Department of Public Health, University of Otago, Wellington, New Zealand.
Department of Public Health, University of Otago, Wellington, New Zealand.
Infect Dis Health. 2023 Feb;28(1):27-38. doi: 10.1016/j.idh.2022.07.002. Epub 2022 Aug 26.
Legionellosis is a collective term used for disease caused by Legionella species which result in community and hospital acquired pneumonia worldwide. The aim of this analysis was to describe the epidemiology of legionellosis hospitalisations in Aotearoa New Zealand (NZ) over a 21-year period and quantify the health care costs.
This study combined national legionellosis notification and hospital discharge data that were linked via the National Health Index (NHI) to provide a more complete dataset of hospitalised cases. The direct cost of hospital care was estimated by multiplying the diagnosis-related group cost-weight by the national price and inflating to 2020/2021 values.
There were 1479 records matched across notifications and discharge databases, including 990 with principal and 489 with additional diagnosis of legionellosis. Incidence rose to an average of 143 cases per annum for 2016-2020, a rate of 3·2/100,000. The median LOS was 6 days (IQR 4-13·5) with direct costs of $2·1 million per annum over that period. Rates were highest in those aged 65 years and above, male, and of European/Other ethnicity. Hospitalisations showed a peak in spring and summer.
The rate of hospitalised legionellosis in New Zealand rose from 2000 to 2015, largely reflecting improved diagnosis. This preventable disease results in substantial health care costs. Greater efforts are needed to identify and control sources of exposure. Surveillance could be improved by routine integration of notification and hospital discharge data.
军团病是一组由军团菌属引起的疾病的统称，可导致全球社区和医院获得性肺炎。本分析的目的是描述 21 年来新西兰（NZ）军团病住院患者的流行病学，并量化医疗保健费用。
本研究结合了国家军团病通知和住院数据，这些数据通过国家健康指数（NHI）进行了链接，从而提供了一个更完整的住院病例数据集。通过将诊断相关组成本权重乘以国家价格并膨胀到 2020/2021 年的值，来估算住院治疗的直接成本。
通知和出院数据库中有 1479 条记录相匹配，包括 990 例主要诊断和 489 例附加诊断的军团病。发病率在 2016-2020 年期间平均每年上升到 143 例，发病率为 3.2/100,000。中位 LOS 为 6 天（IQR 4-13.5），在此期间每年的直接费用为 210 万美元。年龄在 65 岁及以上、男性和欧洲/其他种族的人群发病率最高。住院人数在春季和夏季达到高峰。
新西兰住院军团病的发病率从 2000 年到 2015 年上升，这主要反映了诊断水平的提高。这种可预防的疾病会导致大量的医疗保健费用。需要做出更大的努力来识别和控制暴露源。通过常规整合通知和住院数据，可以提高监测水平。
