Would school closure for the 2009 H1N1 influenza epidemic have been worth the cost?: a computational simulation of Pennsylvania.
Would school closure for the 2009 H1N1 influenza epidemic have been worth the cost?: a computational simulation of Pennsylvania.
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2009年H1N1流感流行的学校关闭是否值得？：宾夕法尼亚州的计算模拟。
DOI：
10.1186/1471-2458-11-353
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发表时间：
2011-05-20
影响因子：
4.5
通讯作者：
Lee BY
中科院分区：
文献类型：
--
作者：
Brown ST;Tai JH;Bailey RR;Cooley PC;Wheaton WD;Potter MA;Voorhees RE;LeJeune M;Grefenstette JJ;Burke DS;McGlone SM;Lee BY
在2009年H1N1流感流行期间，政策制定者就是否、何时以及关闭学校多长时间进行了辩论。虽然关闭学校可以减少流感传播，从而防止病例，死亡和卫生保健费用，但它也可能因儿童保育需求增加以及教师和其他学校员工的生产力损失而产生大量成本。基于代理和蒙特卡洛经济模拟模型相结合，用于确定在2009年H1N1流行期间宾夕法尼亚州关闭学校（与不关闭学校）不同持续时间（范围：1至8周）和症状性病例发病率触发因素（范围：1至30）的成本效益。不同的假设情况将基本生殖率（R 0）从1.2、1.6到2.0不等，并使用2009年流行病的病例住院率和病死率。额外的分析确定了实施学校关闭避免的每个流感病例的成本。在所探讨的所有情况下，关闭学校导致的净费用大大高于不关闭学校。对于R 0 = 1.2、1.6和2.0的流行病，关闭学校8周将导致净成本中位数为210亿美元（95%范围：80 - 453亿美元）。对于R 0 = 1.2，避免的每个流感病例的中位成本为14，185美元（5，423 - 30，565美元），R 0 = 1.6为25，253美元（9，501 - 53，461美元），R 0 = 2.0为23，483美元（8，870 - 50，926美元）。我们的研究表明，在2009年H1N1疫情期间关闭学校可能会给社会带来巨大成本，因为生产力和儿童保育损失的潜在成本可能远远超过预防流感病例所节省的成本。
During the 2009 H1N1 influenza epidemic, policy makers debated over whether, when, and how long to close schools. While closing schools could have reduced influenza transmission thereby preventing cases, deaths, and health care costs, it may also have incurred substantial costs from increased childcare needs and lost productivity by teachers and other school employees. A combination of agent-based and Monte Carlo economic simulation modeling was used to determine the cost-benefit of closing schools (vs. not closing schools) for different durations (range: 1 to 8 weeks) and symptomatic case incidence triggers (range: 1 to 30) for the state of Pennsylvania during the 2009 H1N1 epidemic. Different scenarios varied the basic reproductive rate (R0) from 1.2, 1.6, to 2.0 and used case-hospitalization and case-fatality rates from the 2009 epidemic. Additional analyses determined the cost per influenza case averted of implementing school closure. For all scenarios explored, closing schools resulted in substantially higher net costs than not closing schools. For R0 = 1.2, 1.6, and 2.0 epidemics, closing schools for 8 weeks would have resulted in median net costs of $21.0 billion (95% Range: $8.0 - $45.3 billion). The median cost per influenza case averted would have been $14,185 ($5,423 - $30,565) for R0 = 1.2, $25,253 ($9,501 - $53,461) for R0 = 1.6, and $23,483 ($8,870 - $50,926) for R0 = 2.0. Our study suggests that closing schools during the 2009 H1N1 epidemic could have resulted in substantial costs to society as the potential costs of lost productivity and childcare could have far outweighed the cost savings in preventing influenza cases.
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DOI：
10.1073/pnas.0706849105
发表时间：
2008-03-25
影响因子：
11.1
作者：
Halloran, M. Elizabeth;Ferguson, Neil M.;Cooley, Philip
通讯作者：
Cooley, Philip
影响因子：
5.5
作者：
Chao, Day-Yu;Cheng, Kuang-Fu;Liao, Yu-Hsin
通讯作者：
Liao, Yu-Hsin
影响因子：
5.5
作者：
Lee BY;Brown ST;Cooley PC;Zimmerman RK;Wheaton WD;Zimmer SM;Grefenstette JJ;Assi TM;Furphy TJ;Wagener DK;Burke DS
通讯作者：
Burke DS
影响因子：
5.5
作者：
Lee, Bruce Y.;Brown, Shawn T.;Korch, George W.;Cooley, Philip C.;Zimmerman, Richard K.;Wheaton, William D.;Zimmer, Shanta M.;Grefenstette, John J.;Bailey, Rachel R.;Assi, Tina-Marie;Burke, Donald S.
通讯作者：
Burke, Donald S.
影响因子：
4.5
作者：
Klaiman, Tamar;Kraemer, John D.;Stoto, Michael A.
通讯作者：
Stoto, Michael A.