The annual impact of seasonal influenza in the US: Measuring disease burden and costs
The annual impact of seasonal influenza in the US: Measuring disease burden and costs
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DOI：
10.1016/j.vaccine.2007.03.046
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发表时间：
2007-06-28
期刊：
影响因子：
5.5
通讯作者：
Bridges, Carolyn B.
中科院分区：
文献类型：
--
作者：
Molinari, Noelle-Angelique M.;Ortega-Sanchez, Ismael R.;Bridges, Carolyn B.
背景：尽管采取了预防措施，流感流行仍然在美国造成大量发病率和死亡率。减轻疾病负担的疫苗接种策略已经实施。然而，之前的研究还没有系统地估计流感流行的年度经济负担，这一估计对于有效指导政策制定者是必要的。 目的：我们估计美国每年流感流行造成的特定年龄和风险的疾病负担以及医疗和间接成本。方法：使用概率模型和公开的流行病学数据，我们估计了导致门诊就诊、住院和死亡的流感病例数，以及因缺勤或过早死亡而损失的时间。然后，根据健康保险索赔数据以及收入或统计生命值的预测，我们估计了与流感病例相关的医疗保健资源利用率，以及 2003 年的医疗和生产力（间接）成本。 结果：根据 2003 年美国人口，我们估计每年流感流行导致平均 610,660 生命年损失（未折现）、310 万住院天数和 3140 万门诊病人 访问。直接医疗费用每年平均为 104 亿美元（95% 置信区间 [C.I.]，4.1 美元，22.2 美元）。预计每年因疾病和死亡造成的收入损失达 163 亿美元（C.I.，8.7 美元，31.0 美元）。使用预测的统计生命值计算，年度流感流行的总经济负担达 871 亿美元（C.I.，47.2 美元，149.5 美元）。 结论：这些结果凸显了美国每年流感造成的巨大负担。虽然住院费用是重要的影响因素，但因缺勤和死亡而造成的生产力损失构成了流感经济负担的大部分。 (C) 2007 Elsevier Ltd. 保留所有权利。
Background: Despite preventive efforts, influenza epidemics are responsible for substantial morbidity and mortality every year in the United States (US). Vaccination strategies to reduce disease burden have been implemented. However, no previous studies have systematically estimated the annual economic burden of influenza epidemics, an estimate necessary to guide policy makers effectively.Objective: We estimate age- and risk-specific disease burden, and medical and indirect costs attributable to annual influenza epidemics in the United States. Methods: Using a probabilistic model and publicly available epidemiological data we estimated the number of influenza-attributable cases leading to outpatient visits, hospitalization, and mortality, as well as time lost from work absenteeism or premature death. With data from health insurance claims and projections of either earnings or statistical life values, we then estimated healthcare resource utilization associated with influenza cases as were their medical and productivity (indirect) costs in $2003.Results: Based on 2003 US population, we estimated that annual influenza epidemics resulted in an average of 610,660 life-years lost (undiscounted), 3.1 million hospitalized days, and 31.4 million outpatient visits. Direct medical costs averaged $10.4 billion (95% confidence interval [C.I.], $4.1, $22.2) annually. Projected lost earnings due to illness and loss of life amounted to $16.3 billion (C.I., $8.7, $31.0) annually. The total economic burden of annual influenza epidemics using projected statistical life values amounted to $87.1 billion (C.I., $47.2, $149.5).Conclusions: These results highlight the enormous annual burden of influenza in the US. While hospitalization costs are important contributors, lost productivity from missed work days and lost lives comprise the bulk of the economic burden of influenza. (C) 2007 Elsevier Ltd. All rights reserved.