学校及托幼机构诺如病毒感染性疫情经济负担评估

Assesment of the Economic Burden of Infectious Epidemic Situation of Norovirus Gastroenteritis in Schools and Kindergartens

目的对学校及托幼机构诺如病毒感染性疫情学生家庭和学校的经济负担进行评估,为制定疾病管理策略和控制措施提供依据。方法使用统一问卷进行调查,评估深圳市福田区2017-10/2018-06发生诺如病毒感染性疫情的涉病班级全体学生家庭和学校的经济负担。采用SPSS 22.0软件对数据进行统计分析,均数采用Bootstrap法模拟1 000次抽样后估计95%不确定区间,两组连续变量的比较采用t检验或t′检验,检验水准α=0.05。结果生病学生总经济负担人均721.75(95%UI 606.09~844.39)元,其中直接医疗费用人均148.54(95%UI 118.07~186.89)元,直接非医疗费用人均86.29(95%UI 52.50~124.57)元,间接经济损失人均486.92(95%UI 396.46~586.55)元;健康学生人均经济负担194.32元(95%UI 156.64~236.86),少于生病学生人均总经济负担(t′=7.792,P<0.01),补习费高于生病学生平均补习费(t=0.233,P=0.024);托幼机构生病学生人均总经济负担高于中小学校生病学生(t′=3.060,P=0.003),人均直接医疗费用、间接费用高于中小学校生病学生;托幼机构健康学生人均总经济负担少于中小学校健康学生(t′=7.433,P<0.01),平均误工费、交通费少于中小学校健康学生;随着疫情级别升高,每起疫情平均生病学生负担、健康学生负担、学校负担和疫情总负担都呈现上升趋势;当疫情未达到20例时,以生病学生经济负担为主,当疫情达到20例及以上时,以健康学生经济负担为主。结论诺如病毒感染性疫情疾病经济负担高,相关部门要重视加强预防控制及宣传教育工作;不同类型学校和不同级别疫情诺如病毒感染性疫情经济负担构成比例不同,防控应有侧重点。

Objective To estimate the economic burden of disease of effectious epidemic situation of norovirus gastroenteritis in kindergarten and schools,and to provide the scientific evidence for formulating management strategy and control measures of disease.Methods A unified questionnaire was used to evaluate the economic burden of disease of families and school affected by norovirus infection in Futian district of Shenzhen from October 2017 to June 2018.Software SPSS 22.0 was used for statistical analysis.The mean was simulated by Bootstrap method for 1 000 samples and 95% UI was estimated.The t-test or t’-test was used for the comparision of two groups of continuous variables.Results The survey found that the mean total economic burden of sick students was 721.75(95%UI 606.09-844.39)RMB.The mean direct medical fee,direct non-medical fee and indirect economic burden of sick students was 148.54(95%UI118.07-186.89),86.29(95%UI 52.50-124.57) and 486.92(95%UI396.46-586.55) RMB,respectively.The economic burden of healthy students caused by suspension per capita was 194.32(95%UI 156.64-236.86) yuan,which was less than that of sick students(t’=7.792,P <0.001).The average tutoring expenses of healthy students was higher than that of sick students(t=0.233,P=0.024).The total economic burden per capita of sick students in kindergarten was higher than that of sick students in primary and secondary schools(t’=3.060,P=0.003).The direct and indirect economic expenses of sick students per capita in kindergarten was higher than that of sick students in primary and secondary schools.The total economic burden per capita of healthy students in kindergarten was less than that of healthy students in primary and secondary schools(t’=7.433,P<0.001).The average lost income of work delay and the cost of transportation of healthy students in kindergarten were less than that of healthy students in primary and secondary schools.As the epidemic level increased,the average burden of sick students,healthy students,schools and the total burden of the epidemic all showed an upward trend.When the epidemic cases were less than 20,the financial burden of sick students was the main group,and when the epidemic cases had reached 20 or more,the financial burden of healthy students was the main.Conclusion The economic burden of norovirus infectious epidemic is high,so the relevant departments should attach importance to strengthen prevention and control,publicity and education.The composition ratio of economic burden was different by different types of schools and different epidemic levels of norovirus infection,so the prevention and control work should be targeted.