上海市甲型H1N1流感患者经济负担估计

Economic Burden Estimation of Pandemic Influenza A H1N1 in Shanghai

目的:了解上海市甲型H1N1流感(甲流)大流行期间流感患者的经济负担情况。方法:2009-2010年上海市甲流大流行期间,随机选择流感轻症病例进行问卷调查,所有的甲流重症和死亡病例采用住院病历回顾和流行病学调查相结合的方法,收集流感患者就医相关费用和间接导致的误工旷学等,估计流感病例的经济负担。结果:研究共调查甲流轻症病例132人,重症病例119人,死亡病例9人。甲流轻症病例人均门诊花费265.5元,此外,多数患者还产生了交通、转诊和营养费等,人均直接花费达356.5元,间接经济损失约963.4元。甲流重症病例住院治疗之前,平均就诊3.4次,转诊1.5次,住院费用约为20 712.2元,直接经济支出高达23 832.9元,间接经济损失至少1 962.9元。死亡病例的直接费用则更高,达49 320.2元,所有死亡病例因早死所致间接经济损失合计达1 427.6万元。结论:甲流大流行期间上海市流感患者,尤其是重症患者的经济负担较重,有必要在高危人群中开展疫苗接种工作。

Objective：To estimate the economic burden of pandemic influenza A H1N1 in Shanghai.Methods：During the pandemic influenza A H1N1 from 2009 to 2010,using face to face questionnaire survey,chart review and epidemiological survey,we collected the direct and indirect economic cost of random selected influenza outpatients,all severe hospitalized and death patients in Shanghai.Results：In total,we surveyed 132 outpatients,119 severe inpatients and 9 death cases.The average cost of one outpatient visit is 265.5 yuan,relative direct cost is 356.5 yuan,and indirect cost is about 963.4 yuan.For the severe inpatients,their doctor visit times is about 3.4,refer times between different hospitals is 1.5,hospitalization cost is 20 712.2 yuan,thus,the direct cost of severe patients is 23 832.9 yuan,and indirect cost is 1 962.9 yuan.The direct cost of death cases is much higher,about 49 320.2 yuan,the total indirect economic burden of death cases is 14 276 000 yuan.Conclusion：During the pandemic influenza A H1N1,the economic burden of influenza patients,especially the severe patients,is high.It＇s necessary to take the influenza vaccine for the high risk population.