A Study On Vaccine Related Direct Economic Burden Of Community COPD Patients

Objective:This study explore the direct economic burden and its influencing factors of chronic obstructive pulmonary patients by the year 60-74 in Ningbo.Fully understand the differences in medical costs of COPD patients before and after vaccine intervention.After 1-year follow-up,analysis the cost-benefit of each vaccine group.A reasonable intervention policy should be promoted to effectively promote policies and reasonable financing policy in order to provide policy recommendations.Materials and Methods:This study selected two intergrated chronic noninfectious diseases prevention and control demonstration urban areas(Hai-shu,Jiang-dong)and a comprehensive urban and rural area(Yin-zhou).Our survey choose the COPD patients who met the inclusion and exclusion criteria.This survey obtained basic patient information from the statistic management system and medical record data of local tertiary hospitals,in which we selected the patients into our survey.These patients with COPD visiting hospital in the period of October 2012 to October 2013.We analysis the general condition,direct-economic burden and its influence factor of COPD patients in Ningbo.We find out the difference of direct-economic burden of patient by yearly using influenza,pneumonia vaccines and analysis the cost-benefit of each groups.The direct-economic disease burden consist of two parts: the standing drug costs and the acute exacerbation costs of COPD patients.Results:(1)804 COPD cases average direct-economic burden is 6455.66 yuan,the median is 370.00 yuan..(2)The influencing factors of COPD patients' yearly direct-economic costs is yearly acute episodes,health insurance type for urban workers medical insurance,new agricultural insurance and urban residents insurance,the symptom self-evaluation and patients' s personal income evaluation household consumption range(3)The cost of annual direct-economic burden,standing drugs,hospitalization health care,outpatient health care,additional treatment and the outpatient personal expense in COPD patients who were in influenza vaccine group were statistically significant(P<0.05).(4)The cost of annual direct-economic burden,standing drugs additional treatment and the outpatient personal expense in COPD patients who were in pneumonia vaccine group were statistically significant(P<0.05).(5)The cost of annual direct-economic burden,standing drugs additional treatment and the outpatient personal expense in COPD patients who were in pneumonia and influenza vaccine group were statistically significant(P<0.05).(6)The cost-benefit of different is distinctive: Benefit-cost ratio of influenza vaccine group is 48.67,in pneumonia vaccine group is 18.35,in pneumonia and influenza vaccine group is 9.27.ConclusionTo analysis the influence factors of direct economic burden,the result shows that patients yearly acute episodes,health insurance type for urban workers medical insurance,new agricultural insurance and urban residents insurance,the symptom self-evaluation and patients' s personal income evaluation household consumption range of COPD patients is influence factors.Of which the promotion factors are health insurance type for urban workers medical insurance and urban residents insurance.While,health insurance type for new agricultural insurance,the symptom self-evaluation and patients' s personal income evaluation household consumption range is the backward factor for direct economic burden.Flu and pneumonia vaccine intervention can effectively reduce the direct economic burden of COPD,ningbo should formulate corresponding policies to encourage the flu and pneumonia vaccine intervention for patients with COPD,and intervent and regulate the patient's medical expenses and other costs associated with disease...