Epidemiological Characteristics And Direct Medical Expenses Of Hemorrhagic Fever With Renal Syndrome Vaccines In The Vaccination Areas Of Yichun City From 2005 To 2016

Objective:(1)To master the epidemiological characteristics of hemorrhagic fever of renal syndrome since the introduction of haemorrhagic fever vaccine in yichun city in 2009.(2)To understand the direct medical expenses for the treatment of hemorrhagic fever with renal syndrome in the vaccination area of Yichun city.(3)To explore the effect of intervention measures of hemorrhagic fever of renal syndrome in yichun city,and provide basis for improving prevention and control measures.Methods:(1)Human cases of hemorrhagic fever with renal syndrome and demographic data from 2005 to 2016 in Yichun city were collected.Descriptive epidemiological methods were used to analyze the epidemiological characteristics of hemorrhagic fever with renal syndrome in the the vaccination area of Yichun city from 2005 to 2016,and the prevalence distribution patterns before vaccination(2005-2009)and after vaccination(2010-2016)were analyzed and compared.(2)The census method was used to investigate the direct medical expenses;230 cases were selected by stratified random sampling method for the investigation of direct non-medical costs and indirect costs.Univariate analysis and binary logistic regression analysis were used to screen the influencing factors of economic burden in the vaccination area of Yichun city.Results:(1)From 2005 to 2016,2836 HFRS cases were reported in the vaccination area of Yichun City.The incidence density was 7.61 per 100,000 person-years,and the annual incidence ranged from 5.57 per 100,000 to 10.69 per 100,000.Each area was reported cases,and the incidence density was highest in Shanggao County(21.67/100000).There is a low peak in spring and summer(April-June)and a high peak in autumn and winter(October-January).Each age group all had reported casess,17.38% of which were in 15-59 years-old,Incidence ratio of male and female was 2.12:1.Occupational population is dominated by farmers(70.38%).(2)Compared with pre-inoculation(2005-2009),after vaccinations(2010-2016),the incidence of HFRS reported in these areas showed a rapid upward trend.Only the incidence of disease in Gao'an City decreased,and the inciden ce of Yi'an City,Yifeng,Both Fengfeng and Fengcheng have risen;the age gr oup of 16 to 60 ages had dropped from 80.23% in 2010 to 59.64% in 2016.(3)The median cost of direct medical treatment was 8175.29 yuan,and both the average hospitalization cost and average daily hospitalization cost increased with the increase of the year.The composition ratio of drug costs was the highest,reaching 49.53%.The average medical expenses for HFRS referral cases and severe cases were the highest,at 16608.48 yuan and 11,451.41 yuan respectively.Two-class Logistic regression showed that the factors affecting direct costs were: occupation,the number of hospitalizations,surgery,age,the number of days hospitalized,hospital rank,and clinical classification.Conclusion:(1)The incidence of HFRS in the vaccination area of Yichun city was increased from 2005 to 2016 and mainly occurred in the autumn and winter season,with the age of onset ranging from 15 to 59 years old.The occupation was mainly farmers.(2)Compared with 2005-2009,the HFRS epidemic showed an overall upward trend,but the incidence ratio of HFRS in the 16 to 60 years old vaccine vaccination population showed a decreasing trend,indicating that the HFRS vaccine to some extent curbed the development rate of HFRS.(3)The average direct medical expenses for HFRS in the vaccinated areas have increased with the increase of the year.High drug costs are the main factors that have kept high direct medical costs.The direct medical costs of transfer cases and severe cases are heavier.(4)Occupation,hospitalization,surgery,age,length of stay,hospital grade and clinical classification.were the main factors affecting the economic burden of HFRS in the vaccinated region.(5)It is the key to the current HFRS prevention and control strategy to improve the vaccine coverage rate of the haemorrhagic fever with bivalent renal syndrome in the epidemic area and the effect of the rodent in the epidemic area,the early detection and treatment of severe cases,and the reduction of the patient's level of treatment.