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中高收入国家儿童呼吸道合胞病毒和副流感病毒的经济负担:系统评价。

Economic burden of respiratory syncytial and parainfluenza viruses in children of upper-middle-income countries: a systematic review.

机构信息

Universidade Federal de São Paulo, Escola Paulista de Medicina, Programa de Pós-Graduação em Saúde Baseada em Evidências, São Paulo, SP, Brazil.

Universidade Federal de São Paulo, Escola Paulista de Medicina, Graduação em Medicina, São Paulo, SP, Brazil.

出版信息

J Pediatr (Rio J). 2023 Nov-Dec;99(6):537-545. doi: 10.1016/j.jped.2023.05.003. Epub 2023 May 26.

Abstract

OBJECTIVE

To identify and assess the current evidence available about the costs of managing hospitalized pediatric patients diagnosed with Respiratory Syncytial Virus (RSV) and Parainfluenza Virus Type 3 (PIV3) in upper-middle-income countries.

METHODS

The authors conducted a systematic review across seven key databases from database inception to July 2022. Costs extracted were converted into 2022 International Dollars using the Purchasing Power Parity-adjusted. PROSPERO identifier: CRD42020225757.

RESULTS

No eligible study for PIV3 was recovered. For RSV, cost analysis and COI studies were performed for populations in Colombia, China, Malaysia, and Mexico. Comparing the total economic impact, the lowest cost per patient at the pediatric ward was observed in Malaysia ($ 347.60), while the highest was in Colombia ($ 709.66). On the other hand, at pediatric ICU, the lowest cost was observed in China ($ 1068.26), while the highest was in Mexico ($ 3815.56). Although there is no consensus on the major cost driver, all included studies described that the medications (treatment) consumed over 30% of the total cost. A high rate of inappropriate prescription drugs was observed.

CONCLUSION

The present study highlighted how RSV infection represents a substantial economic burden to health care systems and to society. The findings of the included studies suggest a possible association between baseline risk status and expenditures. Moreover, it was observed that an important amount of the cost is destinated to treatments that have no evidence or support in most clinical practice guidelines.

摘要

目的

确定和评估中高收入国家中住院儿科患者因呼吸道合胞病毒(RSV)和副流感病毒 3 型(PIV3)感染而接受管理的成本的现有证据。

方法

作者对七个关键数据库进行了系统检索,检索时间从数据库建立到 2022 年 7 月。提取的成本已转换为 2022 年国际元,使用购买力平价调整。PROSPERO 标识符:CRD42020225757。

结果

未检索到符合条件的 PIV3 研究。针对 RSV,在哥伦比亚、中国、马来西亚和墨西哥进行了成本分析和 COI 研究。比较总经济影响,儿科病房每位患者的最低成本出现在马来西亚(347.60 美元),而最高成本出现在哥伦比亚(709.66 美元)。另一方面,在儿科 ICU,中国的最低成本为 1068.26 美元,而墨西哥的最高成本为 3815.56 美元。尽管对于主要成本驱动因素没有共识,但所有纳入的研究都表明,药物(治疗)消耗了超过 30%的总成本。观察到高比例的不当处方药物。

结论

本研究强调了 RSV 感染对医疗保健系统和社会造成的重大经济负担。纳入研究的结果表明,基线风险状况和支出之间可能存在关联。此外,观察到大量成本用于治疗,而这些治疗在大多数临床实践指南中没有证据或支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/028f/10594008/870548d3e321/gr1.jpg

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