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台湾地区轮状病毒肠胃炎住院治疗相关的医疗资源利用及照护者负担

Healthcare resource utilization and caregiver burden associated with rotavirus gastroenteritis hospitalizations in Taiwan.

作者信息

Huang Yhu-Chering, Chuang Chih-Hsien, Hsieh Chia-Jung, Hsieh Chiu-Mei, Wu Ying Hui, Lin Questa, Lin Joanne, Qin Fei, Verstraete Janine, Herdman Michael, Carias Cristina

机构信息

Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.

School of Medicine, College of Medicine, Fu-Jen Catholic University, New Taipei, Taiwan.

出版信息

BMC Pediatr. 2025 Jul 23;25(1):565. doi: 10.1186/s12887-025-05711-8.

Abstract

BACKGROUND

Rotavirus infection is a leading cause of acute gastroenteritis in children aged < 5 years. However, few studies assessed the spillover effect on caregivers' health-related quality of life (HRQoL) and out-of-pocket costs associated with rotavirus gastroenteritis (RGE) in Taiwan.

METHODS

This is a prospective, observational, survey-based study conducted in Northern Taiwan between March 2021-September 2023. Caregivers were interviewed during the RGE-hospitalization episode and after patient discharge. One caregiver per child aged ≤ 9 years with clinical presentation of a new RGE hospitalization was enrolled. Outcomes assessed included caregiver HRQoL, emotional state, impact on daily routine, healthcare resource utilization (HCRU), and direct and indirect costs.

RESULTS

The mean age of inpatients was 3.03 years and 69.0% were male. Rotavirus genotype G3P[8] was detected in 61.2% of patients. Caregivers' mean age was 33.7 years, 79.3% were female, and 65.5% had monthly household income < NT$80,000. Caregivers reported significantly higher health state (EQ visual analog scale) after discharge (86.21) than during RGE hospitalization (74.48) (p = 0.049). Among the caregivers, 65.5% and 69.0% experienced disruptions in sleep and leisure activities, respectively. About 45% were worried about complications and 41.4% were concerned about their child's recovery. The total medical costs associated with hospitalization, reimbursed by National Health Insurance, averaged US$575.56. Additional out-of-pocket costs included US$82.51 for medical visits, US$44.95 for transportation, US$5.47 for medication, and US$90.41 for meals outside the home. The caregivers also reported taking an average of 0.12, 1.18, and 1.82 days of child/parental, paid, and unpaid leave, respectively. The estimated wage loss associated with the days not working was US$246.67.

CONCLUSION

RGE poses a significant burden on caregivers' HRQoL, daily activities, and out-of-pocket costs. Interventions aimed at mitigating the spillover effects of RGE on caregivers are essential to improve family well-being.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

轮状病毒感染是5岁以下儿童急性胃肠炎的主要病因。然而,在台湾,很少有研究评估轮状病毒胃肠炎(RGE)对照顾者健康相关生活质量(HRQoL)的溢出效应以及自付费用。

方法

这是一项于2021年3月至2023年9月在台湾北部进行的前瞻性、观察性、基于调查的研究。在RGE住院期间和患者出院后对照顾者进行访谈。纳入每名年龄≤9岁、因新的RGE住院而有临床表现的儿童的一名照顾者。评估的结果包括照顾者的HRQoL、情绪状态、对日常生活的影响、医疗资源利用(HCRU)以及直接和间接费用。

结果

住院患者的平均年龄为3.03岁,69.0%为男性。61.2%的患者检测到轮状病毒基因型G3P[8]。照顾者的平均年龄为33.7岁,79.3%为女性,65.5%的家庭月收入低于新台币80,000元。照顾者报告出院后的健康状况(EQ视觉模拟量表)显著高于RGE住院期间(出院时为86.21,住院期间为74.48)(p = 0.049)。在照顾者中,分别有65.5%和69.0%的人睡眠和休闲活动受到干扰。约45%的人担心并发症,41.4%的人关心孩子的康复。由国民健康保险报销的与住院相关的总医疗费用平均为575.56美元。额外的自付费用包括门诊医疗费用82.51美元、交通费用44.95美元、药品费用5.47美元以及外出就餐费用90.41美元。照顾者还报告平均分别请了0.12天的儿童/家长假、1.18天的带薪假和1.82天的无薪假。与未工作天数相关的估计工资损失为246.67美元。

结论

RGE给照顾者的HRQoL、日常活动和自付费用带来了重大负担。旨在减轻RGE对照顾者溢出效应的干预措施对于改善家庭福祉至关重要。

临床试验编号

不适用。

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