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比利时医疗机构中因肺炎和侵袭性肺炎球菌感染住院患者的健康和经济负担的回顾性研究。

Retrospective study on the health and economic burden of hospitalized patients due to pneumonia and invasive pneumococcal infections in Belgium settings.

机构信息

Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Belgium.

Faculty of Medicine and Pharmacy, Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium.

出版信息

Vaccine. 2024 Apr 30;42(12):3018-3023. doi: 10.1016/j.vaccine.2024.03.057. Epub 2024 Apr 4.

Abstract

INTRODUCTION

pneumococcal infections are associated with high morbidity, hospitalisation and mortality. The objective of this study was to investigate the health and economic burden of all-cause pneumonia and invasive pneumococcal disease in Belgian hospital settings, by patient's age and risk profile.

METHODS

This descriptive retrospective study was conducted in 17 Belgian hospitals. Univariate and multivariate logistic linear regression models were performed. The Health Insurance and patient's cost perspectives were considered because a few studies report these costs.

RESULTS

The analysis has included 4,712 hospital admissions over the year 2018. Median hospitalization costs were higher for invasive pneumococcal infection diagnosis than for all-cause pneumonia (p < 0,001), respectively 4,051€ and 3,362€. Other factors associated with higher hospitalization cost were patient's high-risk profile, admission to emergency unit, transfer from nursing home, admission to intensive care unit and length of stay.

CONCLUSION

Streptococcus pneumoniae infections remain a public health problem with significant cost for the Health Insurance and poor prognosis. Invasive pneumococcal infections are associated with longer hospital stays and required more intensive care than all other causes of pneumonia, in addition to be more costly, which justifies more attention for vaccination. This study also suggests an increase of economic and health burden with age and presence of underlying conditions.

摘要

简介

肺炎球菌感染与高发病率、住院和死亡率有关。本研究的目的是通过患者的年龄和风险状况,调查比利时医院环境中所有病因肺炎和侵袭性肺炎球菌病的健康和经济负担。

方法

这是一项在 17 家比利时医院进行的描述性回顾性研究。进行了单变量和多变量逻辑线性回归模型分析。考虑了健康保险和患者的成本视角,因为很少有研究报告这些成本。

结果

该分析包括了 2018 年的 4712 例住院病例。侵袭性肺炎球菌感染诊断的住院费用中位数高于所有病因肺炎(p<0.001),分别为 4051 欧元和 3362 欧元。其他与住院费用较高相关的因素包括患者的高风险状况、入住急诊部、从养老院转院、入住重症监护病房和住院时间。

结论

肺炎链球菌感染仍然是一个公共卫生问题,对健康保险造成重大负担,且预后较差。侵袭性肺炎球菌感染比其他所有肺炎病因的住院时间更长,需要更多的重症监护,而且费用更高,这证明了接种疫苗需要更多的关注。本研究还表明,随着年龄的增长和基础疾病的存在,经济和健康负担会增加。

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