Damiri Soheila, Goharimehr Mahshad, Nasehi Mohammad Mahdi, Effatpanah Mohammad, Shahali Zahra, Ranjbaran Hossein, Daroudi Rajabali
Department of Health Management, policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Pediatric Neurology Research Center, Research institute for children health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Arch Public Health. 2024 Aug 26;82(1):135. doi: 10.1186/s13690-024-01355-9.
The burden of disease based on disability-adjusted life years (DALYs) is one of the internationally accepted metrics for assessing the impact of a disease or injury on population health. This study aimed to provide evidence of the burden of COVID-19 on health in Iran based on hospital-level data from the Iran Health Insurance Organization (IHIO), which covers almost half of the country's population.
The data of all IHIO enrollees who were referred to hospitals across the country from the beginning of the COVID-19 pandemic (February 2020) to December 30, 2021, with assigned diagnosis codes of COVID-19, were extracted from the hospital information processing system. The DALYs due to COVID-19 were estimated using the standard approach of the World Health Organization and the European Burden of Disease Network guideline.
In the years 2020 and 2021, among a population of about 42 million people, 1,040,367 individuals were admitted to the hospital due to COVID-19 infection, of whom 73% were hospitalized (760,963 patients). The total estimated DALYs for these two years were 665,823 and 928,393, respectively (1,603 and 2,234 per 100,000 population). 99.7% of DALYs were attributed to years of life lost due to premature death (YLLs). The share of the disease burden in the age groups of under 20 years, 20-49 years, 50-80 years, and over 80 years was 6.6%, 26.4%, 58.4%, and 8.6%, respectively.
Based on the hospital-level data estimates, COVID-19 has had a significant burden on health in Iran. COVID-19 was identified as the fifth leading cause of disease burden in Iran during the study period, ranking after cardiovascular diseases, psychological disorders, neoplasms, and musculoskeletal disorders. Additionally, COVID-19 was the third major cause of death, following cardiovascular diseases and neoplasms. Policymaking and the implementation of comprehensive programs to enhance the response of the health system and society to outbreaks of emerging and re-emerging infectious diseases are of utmost importance.
基于伤残调整生命年（DALYs）的疾病负担是国际上公认的评估疾病或伤害对人群健康影响的指标之一。本研究旨在根据伊朗健康保险组织（IHIO）的医院层面数据，提供关于伊朗新冠肺炎对健康造成负担的证据，该组织覆盖了该国近一半的人口。
从医院信息处理系统中提取了2020年2月新冠肺炎疫情开始至2021年12月30日期间，所有被转诊至全国各地医院且被指定诊断为新冠肺炎的IHIO参保人员的数据。采用世界卫生组织的标准方法和欧洲疾病负担网络指南估计新冠肺炎导致的伤残调整生命年。
在2020年和2021年，在约4200万人口中，有1040367人因新冠肺炎感染入院，其中73%（760963名患者）住院治疗。这两年估计的伤残调整生命年总数分别为665823和928393（每10万人口中分别为1603和2234）。99.7%的伤残调整生命年归因于过早死亡导致的生命年损失（YLLs）。20岁以下、20 - 49岁、50 - 80岁和80岁以上年龄组的疾病负担份额分别为6.6%、26.4%、58.4%和8.6%。
根据医院层面的数据估计，新冠肺炎给伊朗的健康带来了重大负担。在研究期间，新冠肺炎被确定为伊朗疾病负担的第五大主要原因，仅次于心血管疾病、心理障碍、肿瘤和肌肉骨骼疾病。此外，新冠肺炎是继心血管疾病和肿瘤之后的第三大主要死因。制定政策并实施综合计划以加强卫生系统和社会对新出现和再次出现的传染病疫情的应对至关重要。
