Study On The Economic Burden Of Influenza And The Cost-effectiveness Of Outbreak Disposal In Honggutan District Of Nanchang City

Objective:1.To understand the incidence and epidemic characteristics of influenza in Honggutan District from 2016 to 2019;2.To evaluate the level of economic burden of confirmed influenza cases and explore the influencing factors of economic burden of influenza cases;3.To estimate the economic losses of the influenza outbreak,evaluate the cost-effectiveness of the treatment of the outbreak,and provide a scientific basis for the formulation of strategies for the prevention and control of infectious diseases.Methods:1.Analyze the incidence and epidemic characteristics of influenza by collecting surveillance data of influenza cases and outbreaks in Honggutan District,Nanchang city,as reported by the"China Information System for Disease Control and Prevention"from 2016 to 2019;Through retrospective investigation of confirmed influenza cases in Honggutan District from 2016 to 2019,the direct economic burden,indirect economic burden and overall economic burden of influenza cases were calculated,and the influencing factors of direct economic burden,indirect economic burden and overall economic burden were analyzed.Data of investigation and treatment of influenza outbreaks confirmed by tests from 2016 to 2019 are collected from local CDC within the jurisdiction,and the epidemic characteristics of influenza outbreaks are described,the economic losses of the outbreaks are calculated,and the costs and benefits of investigation and treatment of the outbreaks are evaluated.2.Descriptive epidemiology and statistical analysis methods were applied.Excel 2007 and SPSS 25.0 software were used to process and analyze the data.Normally distributed measurement data,the use of（±s）description,the skewness distribution of measurement data,using the median（M）and the upper and lower quartiles(P₂₅,P₇₅)is described.The chi-square test or Fisher exact method were used to compare the rates.Rank sum test and logistic regression model were used to analyze the influencing factors of economic burden,with the test level ofα=0.05.Results:1.From 2016 to 2019,682 cases of influenza were reported in Honggutan District.The average reported incidence of influenza in the past four years was48.71/100000,and the overall reported incidence was increasing year by year(χ²_Trend=180.068,P<0.001).Influenza cases were reported in four districts and one township in the whole region,with the highest average annual incidence in Shajing Street（52.50/100000）and the lowest in Shengmi Town（31.36/100000）.The time distribution of influenza varies from year to year.In 2016,the peak of influenza occurred from February to April,with a few cases in the winter of that year.In 2017to 2019,the winter peak occurred from November to February of the following year,with relatively few cases in other months.There were 380 cases in males,with an average annual incidence of 52.27/100,000,and 302 cases in females,with an average annual incidence of 44.86/100,000.The difference was statistically significant（χ²=3.938,P=0.047）.The incidence was highest among children aged 5-9years（373.86/100000）,followed by 0-4 years（177.52/100000）and 10-14 years（111.83/100000）,with cases under 15 years of age accounting for 82.70%of the total cases.The top three occupational distribution of influenza cases were students（317cases）,children in child care（155 cases）and children living in diaspora（109 cases）,accounting for 85.19%of the total cases.From 2016 to 2019,there will be two or more influenza viruses circulating in honggutan New Area every year.2.The median direct economic burden of an outpatient case of influenza was604 yuan,including the median direct medical expenses of 441 yuan and the median direct non-medical expenses of 177 yuan.The median direct economic burden of hospitalized cases was 7486 yuan,including 6083 yuan for direct medical expenses and 1359 yuan for direct non-medical expenses.The median number of days of missed work of influenza outpatient cases was 3 days,the median number of indirect economic burden was 337 yuan,the median number of missed work days of hospitalized cases was 5.5 days,and the median number of indirect economic burden was 618 yuan.Aged under five years old,aged 60 and above,delay of antiviral treatment,high level of diagnosis and treatment hospital is the risk factors forincreased direct economic burden,indirect economic burden and the overall economy burden of influenza cases,ranging in age from 5 to 9 years old is risk factors for increased indirect economic burden and the overall economy burden of influenza cases.The inoculation of influenza vaccine within one year before the onset of influenza is a protective factor for the increase of direct economic burden,indirect economic burden and overall economic burden of influenza cases.Higher educational level of the case or guardian will reduce the risk of increased direct economic burden of influenza cases.3.Influenza outbreaks peak around December and after the start of the school year in the spring of March-April.All the people affected by the influenza outbreak were students and children in kindergartens,with the median age of cases being 7.5years old.The number of influenza outbreaks in primary schools and kindergartens accounted for 94.44 percent of the total.Among the 18 influenza outbreaks,the proportion of H1 influenza was 22.22%,H3 influenza 16.67%,BV influenza 33.33%,BY influenza 16.67%,and mixed infection 11.11%.The 9 influenza outbreaks caused a total economic loss of 380000 yuan,and the cost of conducting epidemic investigation and treatment was about 38000 yuan.It is estimated that 7237secondary cases were reduced,an economic loss of about 7.15 million yuan was recovered,and a net benefit of about 7.11 million yuan was obtained,with acost-benefit ratio of 1:188.Conclusion:1.From 2016 to 2019,the influenza epidemic intensity in Honggutan District increased.The annual peak of influenza incidence was in winter and spring.The incidence of influenza was high among people under 15 years old,and the main groups of influenza cases were students and children in kindergartens.2.The economic burden of influenza cases in Honggutan District from 2016 to2019 is heavy,and the direct medical expenses are the main component of the economic burden of influenza cases.In order to reduce economic losses caused by influenza,it is necessary to avoid influenza infection in children under 5 years old and the elderly over 60 years old,guide influenza cases to receive antiviral treatment as early as possible,and promote influenza vaccination among the public.3.Influenza outbreaks are concentrated in primary schools and kindergartens,causing heavy economic losses.Timely and standardized treatment of the epidemic can significantly reduce the number of cases,reduce economic losses,and produce greatbenefits.