北京市幼儿园和小学水痘暴发疫情控制成本分析

Analysis of varicella outbreaks control cost of kindergartens and primary schools in the perspective of disease prevention and control institutions

目的从疫情防控机构(疾病预防控制、社区卫生机构)和学校的视角,评估北京市幼儿园和小学发生水痘暴发疫情后投入的控制成本。方法回顾性调查北京市4个区2014年6月1日-12月31日发生的12起水痘暴发疫情,调查内容为各类机构在实施各项疫情预防控制措施时投入的人力资本、设备物资、交通及其他费用。结果每起小学水痘暴发疫情平均投入3 910.3人时(折合人力资本184 941.9元),物资/设备费2 988.0元,交通费453.1元,其他费用1 880.8元,共计投入控制成本190 263.0元;每起幼儿园水痘暴发疫情平均投入3 520.6人时(折合人力资本166 608.0元),物资/设备费1 402.3元,交通费262.3元,其他费用92.0元,共计投入控制成本168 364.7元。结论相关机构针对水痘暴发疫情的控制成本明显高于水痘发病给个体带来的经济负担。未来开展水痘疫苗免疫策略经济学评价时,不考虑水痘暴发疫情的控制成本将会低估疫苗接种产生的收益。

Objective To evaluate the cost of varicella outbreaks control in kindergartens and primary schools in the perspective of disease prevention and control institutions such as CDC, local community health centre and schools in Beijing. Methods A retrospective survey was done to investigate varicella outbreaks in kindergartens and schools from 1 June to 31 December in 2014 in 4 districts （Xi Cheng, Chaoyang, Fengtai and Shunyi district） of Beijing. The survey contents include the human capital, equipments/materials, transportation and other expenses for the prevention and control measures of relevant institutions. Results A total of 12 outbreaks cases were surveyed, 3 kindergartens and 9 primary schools. The average cost of a primary school outbreak include 3 910.3 person-hour （ equivalent to ￥ 18 4941.9） , materials/equipments cost ￥2 988. 0, transportations cost ￥453. 1 and other expenses ￥ 1 880.8 with a total investment of ￥190 263.0. The average cost of a kindergarten outbreak include 3 520.6 person-hour （equivalent to ￥166 608.0）, materials/equipments cost￥1 402. 3, transportations cost ￥262.3 and other expenses ￥92.0 with a total investment of ￥168 364.7. Conclusion Varicella outbreak control cost invested from relevant institutions was far more than the economic burden of the case itself. For future economic evaluation of the immunization strategy of varicella vaccine, the benefit of vaccination would be significantly underestimated if the outbreak control cost was ignored.