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The societal cost of rotavirus infection in South Korea

한국에서 로타바이러스 급성 위장관염의 질병 부담

  • Yang, Bong Min (School of Public Health, Seoul National University) ;
  • Jo, Dae Sun (Department of Pediatrics, Medical School, Chonbuk National University) ;
  • Kim, Youn Hee (School of Public Health, Seoul National University) ;
  • Hong, Ji Min (School of Public Health, Seoul National University) ;
  • Kim, Jung Soo (Department of Pediatrics, Medical School, Chonbuk National University)
  • 양봉민 (서울대학교 보건대학원) ;
  • 조대선 (전북대학교 의학전문대학원 소아과학교실) ;
  • 김윤희 (서울대학교 보건대학원) ;
  • 홍지민 (서울대학교 보건대학원) ;
  • 김정수 (전북대학교 의학전문대학원 소아과학교실)
  • Received : 2008.02.02
  • Accepted : 2008.08.05
  • Published : 2008.09.15

Abstract

Purpose : This study aims to estimate the financial cost of rotavirus infection in Korea in the year of 2005. Methods : The incidence rates used were from the epidemiological profile at Jeoungeub District (5.8 cases/1,000 children <5 years old for inpatients, and 22.65 cases/1,000 children <5 years old for outpatients, per year). The health care cost per capita of rotavirus infection (ICD code: A08.0) was extracted from the Health Insurance Review and Assessment Service database in Korea. The patient survey was conducted to capture information about non-medical costs and associated productivity loss incurred by adult caregivers. Results : The number of annual national cases among children <5 years old with rotavirus infection was estimated to be 69,122 (i.e., 55,030 outpatients and 14,092 inpatients). The total cost of rotavirus infection was estimated at 13.3 billion Korean won, comprising 11 billion Korean won (82.7%) of direct medical costs, 1.6 billion Korean won (12.0%) of direct non-medical costs (e.g., transportation and supplies), and 0.68 billion Korean won (5.1%) of productivity lost by adult caregivers. Conclusion : Rotavirus infection carries not only medical costs but also non-medical and indirect costs; together, these costs incur a significant burden on South Korean society. The impact of rotavirus on quality of life and health among patient caregivers was not considered in this study, but it does merit further research.

목 적 : 사회적 관점에서 로타바이러스의 사회적 비용을 추계하고자 하였다. 방 법 : 로타바이러스 연간 발생 환자수는 2002년 7월에서 2004년 6월까지 정읍지역에서 보고된 5세 미만 인구 1,000명당 입원 환자 11.6명, 외래 환자는 1,000명당 45.3명을 1년 단위로 환산하여 적용하였으며 의료비 자료는 건강보험심사평가원에 로타바이러스(A08.0)로 청구된 자료를 이용하였다. 2006년 12월부터 2007 년 5월까지 환자 보호자 조사를 실시하여 직접 비의료비 및 간접 비용을 산출하는 근거로 사용하였다. 결 과 : 2005년 5세 미만 아동 중 로타바이러스 감염으로 외래 이용한 환자수는 55,030명, 입원 환자수는 14,092명으로 추정하였다. 의료 비용은 110억원으로 전체의 82.8%를 차지했고, 교통비 및 기저귀 사용 등으로 인한 직접 비의료비는 16억원, 간호에 따른 작업 손실 비용은 6억 8000만원으로 로타바이러스 감염으로 인한 총 사회적 비용은 약 132억원 8천만원으로 집계되었다. 결 론 : 로타바이러스 감염은 의료비 뿐 아니라 비의료비와 간접 비용의 추가적인 지출을 가져오며 이는 사회적으로 큰 손실이 될 것이다. 그러나 본 연구에서는 보수적 추정을 하였으며 추후 연구에서 로타바이러스 감염이 보호자의 삶의 질과 건강수준의 저하에 미치는 영향을 비용 항목에서 충분히 고려할 필요가 있다.

Keywords

Acknowledgement

Supported by : Glaxosmithkline

References

  1. Cook SM, Glass RI, LeBaron CW, Ho MS. Global seasonality of rotavirus infections. Bull World Health Organ 1990;68:171-7
  2. Parashar UD, Hummelman EG, Bresee JS, Miller MA, Glass RI. Global illness and deaths caused by rotavirus disease in children. Emerg Infect Dis 2003;9:565-72 https://doi.org/10.3201/eid0905.020562
  3. Seo JK, Sim JG. Overview of rotavirus infections in Korea. Pediatrics International 2000;42:406-10 https://doi.org/10.1046/j.1442-200x.2000.01250.x
  4. Kim JS, Kang JO, Cho SC, Jang YT, Min SA, Park TH, et al. Epidemiological profile of rotavirus infection in the Republic of Korea: results from prospective surveillance in the Jeongeub District, 1 July 2002 through 30 June 2004. J Infect Dis 2005;192 Suppl 1:S49-56 https://doi.org/10.1086/431506
  5. The paediatric Rotavirus European Committee. The pediatric burden of rotavirus disease in Europe. Epidemiol Infect 2006;134:908-16 https://doi.org/10.1017/S0950268806006091
  6. Kilgore PE, Holman RC, Clarke MJ, Glass RI. Trends of diarrheal disease associated mortality in US children, 1968 through 1991. JAMA 1995;274:1143-8 https://doi.org/10.1001/jama.274.14.1143
  7. Chan PK, Tam JS, Nelson EA, Fung KS, Adeyemi-doro FA, Fok TF, et al. Rotavirus infection in Hong Kong: epidemiology and estimates of disease burden. Epidemiol Infect 1998;120:321-5 https://doi.org/10.1017/S0950268898008747
  8. Tucker AW, Haddix AC, Bresee JS, Holman RC, Parashar UD, Glass RI. Cost-effectiveness analysis of a rotavirus immunization program for the United States. JAMA 1998;279:1371-6 https://doi.org/10.1001/jama.279.17.1371
  9. Johansen K, Bennet R, Bondesson K, Eriksson M, Hedlund KO, Verdier-Klingenberg KD, et al. Incidence and estimates of the disease burden of rotavirus in Sweden. Acta Paediatr Suppl 1999;88:20-3 https://doi.org/10.1111/j.1651-2227.1999.tb14321.x
  10. Vesikari T, Rautanen T, Von Bonsdorff CH. Rotavirus gastroenteritis in Finland: burden of disease and epidemiological features. Acta Paediatr Suppl 1999;88:24-30
  11. Mrukowicz JZ, Krobicka B, Duplaga M, Kowalska-Duplaga K, Domanski J, Szajewska H, et al. Epidemiology and impactof rotavirus diarrhoea in Poland. Acta Paediatr Suppl 1999;88:53-60
  12. Holmes WR. Rotavirus infection and rates of hospitalisation for acute gastroenteritis in young children in Australia, 1993-1996. Med J Aust 1999;170:189-90
  13. Carlin JB, Jackson T, Lane L, Bishop RF, Barnes GL. Cost effectiveness of rotavirus vaccination in Australia. Aust N Z J Public Health 1999;23:611-6 https://doi.org/10.1111/j.1467-842X.1999.tb01546.x
  14. Lee BP, Azimi PH, Staat MA, Louie L, Parada E, Berke T, et al. Nonmedical costs associated with rotavirus disease requiring hospitalization. Pediatr Infect Dis J 2005;24:984-8 https://doi.org/10.1097/01.inf.0000183754.29707.cd
  15. Nelson EA, Tam JS, Yu LM, Ng YC, Bresee JS, Poon KH, et al. Hospital-based study of the economic burden associated with rotavirus diarrhea in Hong Kong. J Infect Dis 2005;192 Suppl 1:S64-70 https://doi.org/10.1086/431493
  16. Podewils LJ, Antil L, Hummelman E, Bresee J, Parashar UD, Rheingans R. Projected cost-effectiveness of rotavirus vaccination for children in Asia. J Infect Dis 2005;192 Suppl 1:S133-45 https://doi.org/10.1086/431513
  17. Gleizes O, Desselberger U, Tatochenko V, Rodrigo C, Salman N, Mezner Z, et al. Nosocomial rotavirus infection in European countries: a review of the epidemiology, severity and economic burden of hospital-acquired rotavirus disease. Pediatr Infect Dis J 2006;25:S12-21 https://doi.org/10.1097/01.inf.0000195626.35239.58
  18. Lu CY, Lauderdale TL, Fang YH, Wang CY, Ho YH, Hung CL, et al. Disease burden and related medical costs of rotavirus infections in Taiwan. BMC Infect Dis 2006;6:176 https://doi.org/10.1186/1471-2334-6-176
  19. Malek MA, Curns AT, Holman RC, Fischer TK, Bresee JS, Glass RI, et al. Diarrhea- and rotavirus-associated hospitalizations among children less than 5 years of age: United States, 1997 and 2000. Pediatrics 2006;117:1887-92 https://doi.org/10.1542/peds.2005-2351
  20. Rheingans RD, Heylen J, Giaquinto C. Economics of rotavirus gastroenteritis and vaccination in Europe: what makes sense? Pediatr Infect Dis J 2006;25:S48-55 https://doi.org/10.1097/01.inf.0000197566.47750.3d
  21. Soriano-Gabarro M, Mrukowicz J, Vesikari T, Verstraeten T. Burden of rotavirus disease in European Union countries. Pediatr Infect Dis J 2006;25:S7-S11 https://doi.org/10.1097/01.inf.0000197622.98559.01
  22. Harris JP, Jit M, Cooper D, Edmunds WJ. Evaluating rotavirus vaccination in England and Wales. Part I. Estimating the burden of disease. Vaccine 2007;25:3962-70 https://doi.org/10.1016/j.vaccine.2007.02.072
  23. Widdowson MA, Meltzer MI, Zhang X, Bresee JS, Parashar UD, Glass RI. Cost-effectiveness and potential impact of rotavirus vaccination in the United States. Pediatrics 2007;119:684-97 https://doi.org/10.1542/peds.2006-2876
  24. Hsu VP, Staat MA, Roberts N, Thieman C, Bernstein DI, Bresee J, et al. Use of active surveillance to validate international classification of diseases code estimates of rotavirus hospitalizations in children. Pediatrics 2005;115:78-82 https://doi.org/10.1542/peds.2004-0860
  25. Newall AT, MacIntyre R, Wang H, Hull B, Macartney K. Burden of severe rotavirus disease in Australia. J Paediatr Child Health 2006;42:521-7 https://doi.org/10.1111/j.1440-1754.2006.00915.x
  26. Carlin JB, Chondros P, Masendycz P, Bugg H, Bishop RF, Barnes GL. Rotavirus infection and rates of hospitalisation for acute gastroenteritis in young children in Australia, 1993-1996. Med J Aust 1998;169:252-6
  27. Kim JH, Chung JC, Lee HY, Choi SJ, Lee JK. Out of pocket payment in Korean health insurance in 2005. National Health Insurance Corporation. 2006
  28. Chung KO, Lee DS, Kim DK, Choi SM, Kim WT, Yu SH. Study of nosocomial infection of rotavirus in preterm and full-term neonates. J Korean Pediatr Soc 1999;42:332-8
  29. Lee HJ, Choi HR, Cho SJ, Seo JW, Park EA. Rotavirus infection in the nursery. Korean J Perinatol 2003;14:36-41
  30. Lee SY, Kim HJ, Kim MY. Kim WD, Lee DS, Kim DK, et al. The difference between clinical manifestations and feeding or delivery methods in healthy full-term neonates and those with nosocomial rotavirus infection. J Korean Pediatr Soc 2003;46:454-8
  31. Lim SH, Koe YS, Jo DS, Lee SJ, Hwang PH, Kligore P, et al. Pediatrician perspectives on the evaluation and treatment of acute gastrointestinal infections, Jeonbuk, South Korea, 2002. J Korean Pediatr Soc 2003;46:1217-23

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