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在爱尔兰,引入普遍轮状病毒疫苗接种对轮状病毒肠胃炎相关住院的经济学影响。

The economic impact of the introduction of universal rotavirus vaccination on rotavirus gastroenteritis related hospitalisations in children in Ireland.

机构信息

Department of Economics, Cork University Business School, University College Cork, Ireland.

Department of Economics, Cork University Business School, University College Cork, Ireland.

出版信息

Vaccine. 2023 Apr 17;41(16):2656-2663. doi: 10.1016/j.vaccine.2023.03.010. Epub 2023 Mar 21.

Abstract

BACKGROUND

Rotavirus gastroenteritis (RVGE), a vaccine preventable disease, remains a common cause of severe gastroenteritis in children globally. Ireland introduced the universal rotavirus vaccination to the national immunisation programme in 2016. In this paper the economic impact on RVGE related hospitalisations amongst children under 5 years is examined.

METHODS

Using national data from all Irish public hospitals, an Interrupted Times Series Analysis (ITSA) compares RVGE hospitalisations amongst children under 5 years, pre- and post-vaccine introduction. Costs are estimated and ITSA results are compared to the counterfactual to estimate the economic impact of the vaccine. A probit model examines patient characteristics pre- and post-vaccine introduction.

RESULTS

Vaccine introduction coincided with lowered RVGE related hospitalisations. While this effect was delayed (1 year) there is evidence of a sustained impact. RVGE patients' post-vaccine introduction were likely to be over 2 years (p = 0.001) and length of stay was lower on average (p = 0.095). The counterfactual analysis revealed 492 RVGE hospitalisations were avoided on average annually since the introduction of the vaccine. This has an estimated economic value of €0.92 million per annum.

CONCLUSIONS

Following the introduction of the rotavirus vaccine in Ireland, hospitalisations for RVGE decreased significantly and those hospitalised were older and with a reduced length of stay on average. This has the potential for significant cost savings for the Irish healthcare system.

摘要

背景

轮状病毒胃肠炎(RVGE)是一种可通过疫苗预防的疾病,仍然是全球儿童严重胃肠炎的常见病因。爱尔兰于 2016 年将轮状病毒疫苗纳入国家免疫计划。本文研究了轮状病毒疫苗接种对 5 岁以下儿童 RVGE 相关住院的经济影响。

方法

利用爱尔兰所有公立医院的国家数据,采用中断时间序列分析(ITSA)比较了疫苗接种前后 5 岁以下儿童的 RVGE 住院情况。对成本进行了估算,并将 ITSA 结果与反事实进行了比较,以估计疫苗的经济影响。使用概率单位回归模型检验了疫苗接种前后患者的特征。

结果

疫苗接种的引入与 RVGE 相关住院率的降低有关。尽管这种影响是滞后的(1 年),但仍有持续影响的证据。RVGE 患者在接种疫苗后更有可能超过 2 岁(p = 0.001),平均住院时间更短(p = 0.095)。反事实分析表明,自疫苗接种以来,每年平均可避免 492 例 RVGE 住院。这具有每年 92 万欧元的估计经济价值。

结论

在爱尔兰引入轮状病毒疫苗后,RVGE 的住院人数显著下降,住院患者年龄更大,平均住院时间更短。这有可能为爱尔兰的医疗保健系统节省大量成本。

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