Influenza-Like-Illness and Clinically Diagnosed Flu: Disease Burden, Costs and Quality of Life for Patients Seeking Ambulatory Care or No Professional Care at All
Influenza-Like-Illness and Clinically Diagnosed Flu: Disease Burden, Costs and Quality of Life for Patients Seeking Ambulatory Care or No Professional Care at All
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DOI：
10.1371/journal.pone.0102634
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发表时间：
2014-07-17
期刊：
影响因子：
3.7
通讯作者：
Beutels, Philippe
中科院分区：
文献类型：
--
作者：
Bilcke, Joke;Coenen, Samuel;Beutels, Philippe
这是第一批研究之一：(1)描述流感样疾病（ILI）和临床诊断的流感的院外负担，也适用于不寻求专业医疗护理的患者；(2)评估有影响的背景特征；(3)正式比较有和没有临床诊断为流感的患者的ILI负担。在比利时2011-2012年流感季节招募了近期有流感病例的一般人群样本。2250名受访者中有一半寻求专业医疗护理，报告的症状更多（特别是更常见的发烧），疾病持续时间更长，药物使用更多（特别是抗生素），直接医疗费用高于不寻求医疗护理的患者。无论门诊ILI患者是否接受过流感临床诊断，其疾病和经济负担相似。他们在6天内平均出现5-6种症状；需要1.6次就诊，86-91%的患者服药。平均一次发作相当于直接医疗费用的51倍——53倍，旷工或旷课4天，损失0.005质量调整生命年。潜在的疾病导致更高的费用和更低的生活质量。临床诊断为流感的ILI患者的成本随年龄的增长呈增加趋势，而未诊断为流感的ILI患者的成本随年龄的增长呈下降趋势。最近接种疫苗的人费用较低，生活质量较高，但这只是不寻求专业医疗护理的患者的情况。这些信息可直接用于评估具有成本效益的流感预防和控制措施的实施情况。特别是为评估包括儿童在内的更广泛的季节性流感疫苗接种提供信息，这是许多国家目前正在考虑的。
This is one of the first studies to (1) describe the out-of-hospital burden of influenza-like-illness (ILI) and clinically diagnosed flu, also for patients not seeking professional medical care, (2) assess influential background characteristics, and (3) formally compare the burden of ILI in patients with and without a clinical diagnosis of flu. A general population sample with recent ILI experience was recruited during the 2011-2012 influenza season in Belgium. Half of the 2250 respondents sought professional medical care, reported more symptoms (especially more often fever), a longer duration of illness, more use of medication (especially antibiotics) and a higher direct medical cost than patients not seeking medical care. The disease and economic burden were similar for ambulatory ILI patients, irrespective of whether they received a clinical diagnosis of flu. On average, they experienced 5-6 symptoms over a 6-day period; required 1.6 physician visits and 86-91% took medication. An average episode amounted to is an element of 51-is an element of 53 in direct medical costs, 4 days of absence from work or school and the loss of 0.005 quality-adjusted life-years. Underlying illness led to greater costs and lower quality-of-life. The costs of ILI patients with clinically diagnosed flu tended to increase, while those of ILI patients without clinically diagnosed flu tended to decrease with age. Recently vaccinated persons experienced lower costs and a higher quality-of-life, but this was only the case for patients not seeking professional medical care. This information can be used directly to evaluate the implementation of cost-effective prevention and control measures for influenza. In particular to inform the evaluation of more widespread seasonal influenza vaccination, including in children, which is currently considered by many countries.