McBean A M, Babish J D, Warren J L
Epidemiology Branch, Health Care Financing Administration, Baltimore, MD 21207.
Arch Intern Med. 1993 Sep 27;153(18):2105-11.
Traditional methods of measuring the impact and cost of influenza virus have focused on epidemic years and morbidity and mortality due to pneumonia and influenza.
Annualized age-sex-race adjusted rates of hospitalization for pneumonia and influenza and other diagnoses among elderly Medicare beneficiaries during the epidemic influenza season of 1989 to 1990 and the nonepidemic season of 1990 to 1991 were compared with an interim period in 1990 without influenza virus circulation.
The rates of hospitalization for pneumonia and influenza, acute bronchitis, chronic respiratory disease, and congestive heart failure were significantly greater during each influenza period compared with the interim period. The highest rates were found in the epidemic season of 1989 to 1990. The amount reimbursed by Medicare to hospitals to 1990. The amount reimbursed by Medicare to hospitals for the treatment of excess hospitalizations during periods of influenza activity was more than $1 billion in 1989 to 1990 and almost $750 million in 1990 to 1991.
Measures of the impact and cost of influenza in elderly Americans should include all of the diagnoses listed above and should recognize that the impact of influenza virus is significant even in nonepidemic years. There are great opportunities for cost savings if effective control programs are implemented.
传统的衡量流感病毒影响和成本的方法主要集中在流行年份以及肺炎和流感导致的发病率和死亡率上。
将1989年至1990年流感流行季节以及1990年至1991年非流行季节期间老年医疗保险受益人中按年龄、性别、种族调整后的肺炎和流感及其他诊断的年度住院率与1990年无流感病毒传播的中间时期进行比较。
与中间时期相比，每个流感时期肺炎和流感、急性支气管炎、慢性呼吸道疾病以及充血性心力衰竭的住院率显著更高。最高住院率出现在1989年至1990年的流行季节。医疗保险向医院报销的金额至1990年。1989年至1990年流感活动期间医疗保险因超额住院治疗向医院报销的金额超过10亿美元，1990年至1991年接近7.5亿美元。
衡量美国老年人流感影响和成本的指标应包括上述所有诊断，并且应认识到即使在非流行年份流感病毒的影响也很显著。如果实施有效的控制计划，节省成本的机会很大。
