| Section1Epidemiology and clinical characteristics of hospitalized children under5Years admitted to the Children’s HospitalObjective:To understand the viral pathogens, seasonal distribution and clinical characteristics of children under5years old admitted to Suzhou children hospital with SARI (Severe Acute Respiratory Infection), so as to provide clues for the clinical diagnosis and treatment, prevention and control of SARI cases at Suzhou.Methods:Perspective study. Study was conducted from March2011to Octorber2012in children<5years hospitalized in respiratory wards at Suzhou Children Hospital with SARI. We sampled the children’s nasopharyngeal aspirate specimens for laboratory testing. Medical history and clinical characteristics were collected as well. Statistical analysis was performed using SPSS software version16.0.Results:In total, there were1567SARI cases were included and1126cases were sampled and analyzed. The positive rate of viruses was37.40%.185cases with respiratory syncytial virus (positive rate16.4%), type B influenza virus in67cases (6.0%), influenza virus type A88cases (7.8%), adenovirus32cases (2.8%), parainfluenza Ⅰ type16cases (1.4%), parainfluenza II type1case (0.1%), parainfluenza Ⅲ type57cases (5.1%). Influenza virus was mainly popular in spring, summer and winter, and the epidemic seasons of respiratory syncytial virus were spring, autumn and winter. The positive rate of RSV in males was higher than in female (p<0.05); the positive rate of influenza, RSV, adenovirus, parainfluenza virus were significant different among different age groups (P<0.05). The incidence of cough, gasper and pneumonia were different between the positive and negative cases (p<0.05) and the incidence was higher in positive ones. The positive rates of RSV or PIV in pneumonia were higher than in other diagnoses (p<0.05). The shortest admission time for SARI children was1day, the longest time was44days, and the median was7days. Treatment of oxygen therapy in the process of children’s hospital stay was significantly more than children not use oxygen. Deputy influenza virus and respiratory syncytial virus infection were significantly longer than the other children virus infection for the length of hospital stay of male in hospital. The length of hospital stay of adenovirus infection children under2years was significantly longer than other virus infected children.Conclusions:Respiratory Syncytial Virus (RSV) and Influenza were the most predominant pathogens in children under5years with SARI at Suzhou, and viral infection may be aggravated clinical symptoms of SARI cases. Different viral infections had different clinical features. Influenza virus mainly caused respiratory infections and pneumonia, and RSV causes bronchiolitis mainly.Section2Costs burden of hospitalized children under5Years admitted to the Children’s HospitalObjective To describe the distribution and analyze the influencing factors of the hospitalization cost under the age of5cases with severe acute respiratory tract infection in Suzhou, and understanding financial burden related to hospitalization, so as to provide data evidence for respiratory infection immunization strategy and the economic benefits of influenza vaccination.Methods:Perspective study. We collected the various hospitalization costs and non-medical cost information of the study objects according to historical information system (HIS) of Suzhou Children’s Hospital and telephone back-visiting. The influencing factors of hospitalization costs were analyzed with univariate analysis and logistic regression. Statistical analysis was performed using SPSS software version16.0.Results:From2011to2012, the highest, lowest and media hospitalization expense of children with severe acute respiratory infection were63439,1082and4382Yuan, respectively. No statistically significant difference was observed between three age groups (0to6m,7to24m, and25to60m) for hospitalization cost, however, it has a rising trend as children age growth. Diagnosis and treatment costs accounted for47.6%of the hospitalization expense, and Inspection charge was about44.4%. For Inspection fee, inspection fee was highest; drug costs was highest in the diagnosis and give treatment cost; and for nursing and other expenses, the bed cost was highest. Children with insurance hospitalization expense were higher than uninsured children for per capita and average daily hospitalization cost. In different age groups, the deputy flu virus infected children hospitalization cost of0to6m group was statistically significant higher than other children,7to24m group of adenovirus infection in children in the hospital fees was significantly higher than other children (P<0.05). Single factor analysis found that7to24months (OR=1.72), and25to60months (OR=2.44) group of children hospitalized fee was higher than0and6month group, children with oxygen treatment in the process of hospital cost was significantly higher than children without oxygen (OR=3.98), and the hospitalization cost of children use glucocorticoid was higher than children not use glucocorticoid drugs (OR=4.62), the cost of children with long length of hospital stay was significantly higher than children with short hospital stay (OR=1.94). Logistic regression analysis found that24to60m age group (OR=2.63), oxygen (OR=7.49), sugar cortical hormone (OR=2.74) and length of hospital stay (OR=2.17) was statistically significant on hospitalization cost. For the non-medical costs, the highest was wage costs (55.0%), the least was nurse or care costs (0.5%), and the median of total non-medical costs (IQR) was715Yuan (248-1648). Suburban hospital of medical cost loss in children, lost wages of parents and transportation costs were significantly higher than urban children (P<0.01), non-medical expense and average daily per capita medical costs were also significantly higher than urban children (P<0.01). Hospitalization costs associated with the family burden of per person were710and1692Yuan for children with and without insurance.Conclusions The costs of children with economic burden Severe acute respiratory infection under five years old in Suzhou hospital is heavy, and this might be affected by the length of time, oxygen use, glucocorticoid use and the age of sick children. Per capita economic burden of the family associated with severe acute respiratory infections is higher. Related respiratory vaccines, especially influenza vaccine immunization could help reduce the economic burden for the hospitalized children. |
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