Swansea Centre for Health Economics, Faculty of Medicine, Health and Life Science, Swansea University, Singleton Park, Swansea, SA2 8PP, UK.
Population Data Science, Faculty of Medicine, Health and Life Science, Swansea University, Singleton Park, Swansea, SA2 8PP, UK.
BMC Public Health. 2023 Nov 26;23(1):2342. doi: 10.1186/s12889-023-17169-3.
The EVITE Immunity study investigated the effects of shielding Clinically Extremely Vulnerable (CEV) people during the COVID-19 pandemic on health outcomes and healthcare costs in Wales, United Kingdom, to help prepare for future pandemics. Shielding was intended to protect those at highest risk of serious harm from COVID-19. We report the cost of implementing shielding in Wales.
The number of people shielding was extracted from the Secure Anonymised Information Linkage Databank. Resources supporting shielding between March and June 2020 were mapped using published reports, web pages, freedom of information requests to Welsh Government and personal communications (e.g. with the office of the Chief Medical Officer for Wales).
At the beginning of shielding, 117,415 people were on the shielding list. The total additional cost to support those advised to stay home during the initial 14 weeks of the pandemic was £13,307,654 (£113 per person shielded). This included the new resources required to compile the shielding list, inform CEV people of the shielding intervention and provide medicine and food deliveries. The list was adjusted weekly over the 3-month period (130,000 people identified by June 2020). Therefore the cost per person shielded lies between £102 and £113 per person.
This is the first evaluation of the cost of the measures put in place to support those identified to shield in Wales. However, no data on opportunity cost was available. The true costs of shielding including its budget impact and opportunity costs need to be investigated to decide whether shielding is a worthwhile policy for future health emergencies.
EVITE 免疫研究调查了在 COVID-19 大流行期间对英国威尔士的临床极度脆弱(CEV)人群进行保护对健康结果和医疗保健成本的影响,以帮助为未来的大流行做准备。保护的目的是保护那些面临 COVID-19 严重伤害风险最高的人。我们报告了在威尔士实施保护的成本。
从安全匿名信息链接数据库中提取了进行保护的人数。使用已发表的报告、网页、向威尔士政府提出的信息自由请求以及个人通信(例如与威尔士首席医疗官办公室的通信),对 2020 年 3 月至 6 月期间支持保护的资源进行了映射。
在开始进行保护时,有 117415 人在保护名单上。在最初的 14 周大流行期间,建议这些人留在家中以支持他们的总额外费用为 13307654 英镑(每个被保护者 113 英镑)。这包括编制保护名单、通知 CEV 人员保护干预措施以及提供药品和食品配送所需的新资源。在 3 个月的时间内,该名单每周都进行调整(到 2020 年 6 月,有 13 万人确定)。因此,每个被保护者的费用在 102 至 113 英镑之间。
这是对威尔士为支持被确定进行保护的人而采取的措施的成本的首次评估。但是,没有关于机会成本的数据。需要调查屏蔽的真实成本,包括其预算影响和机会成本,以确定屏蔽是否是未来卫生紧急情况的一项有价值的政策。