Abstract:
Worldwide, rotavirus is the principal cause of diarrheal illness in young children. Rotavirus infection causes significant morbidity and mortality, often inflicting emotional distress and financial burden on the family and the society.
Disease surveillance has revealed that the incidence of rotavirus infections in infants and young children is similar in both developing and developed countries. Despite so, the burden of mortality is most pronounced in the poorest countries with limited healthcare access, while morbidity is of greater significance in the developed countries. Asia’s diverse populations and economies therefore present a full spectrum of disease burden. The main drivers of rotavirus burden are direct costs (e.g., hospitalizations) and indirect costs (e.g., loss of productivity). Indirect costs are substantial in industrialized counties. The estimated annual social and medical costs due to rotavirus infections in the United States were over US $1 billion and US $264 million, respectively, demonstrating a clear emphasis of indirect over direct cost. In contrast, the estimated annual social and hospital costs for rotavirus-associated admission in Taiwan were US $13.3 million and US $10.4 million, respectively, showing the equivalence in direct and indirect cost burden.
Although few countries have evaluated its economic impact or considered the potential cost effectiveness (CE) of rotavirus universal mass vaccination (UMV), the magnitude of rotavirus disease burden is recognized. Rotavirus vaccine could markedly alleviate the ensuing disease toll on both society and the economy but to maximize its benefits, it will be important to increase its coverage.
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Abbreviations
- AGE:
- ARSN:
- BNHI:
-
Bureau of National Health Insurance
- CE:
-
cost effectiveness
- COI:
-
cost-of-illness
- GAVI:
- ICD-9 CM codes:
-
International Classification of Disease, ninth edition, Clinical Modification Code (ICD-9 CM Code)
- LOS:
- OPD:
-
out-patient department
- ORT:
- RT-PCR:
-
reverse transcription-polymerase chain reaction
- SH:
- UMV:
-
universal mass vaccination
- WHO:
-
World Health Organization
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Appendix
Appendix
1.1 Costs Calculated Among Inpatient
1. Total direct costs included total SH costs and total family expenditure:
-
(1)
Total SH costs = SH inpatient cost + SH outpatient cost + SH ward follow-up cost
-
(2)
SH inpatient cost = (total number of days in SH hospital) × (cost of a general pediatric SH hospital bed bed/day); where the SH calculates bed costs by using full cost estimates. All four sentinel hospitals conducted similar calculations on an annual basis. The pediatric costs are calculated for pediatric beds. The latter figure was used to calculate SH inpatient costs and was estimated by escalating 2001–2001 cost data to 2002–2003 price levels Table 71-6 . All costs, including medications and diagnostic tests, are included in the per diem cost
-
(3)
SH outpatient cost = (number of Hospital outpatient department (HOPD) visits × official cost/HOPD visit) + (number of a Accident & Emergency [A&E] visit × official cost/A&E visit), which includes all visits related to the same episode of gastroenteritis that required admission and occurred either before or after hospitalization
-
(4)
SH ward follow-up (WFU) cost = (number of WFU visits) × (official cost/WFU)
2. The total family expenditure included all co-payments made by the family to the SH hospitals or clinics (family SH costs) and total family costs and was calculated as follows:
-
(1)
Family SH costs = (total days in SH hospital) × (official cost of co-pay a pediatric SH bed per day paid by family) + (number of WFU visits) × (official cost of co-pay per WFU paid by family) + (number of OPD visits × official cost of co-pay per OPD visit paid by family) + (number of A&E visits × official cost of co-pay per A&E visit paid by family)
-
(2)
Total family costs = family “other provider” cost + family travel costs + family “other related” costs
-
(3)
Family “other provider” costs = actual cost of co-payment for any other provider costs, including cost of non-SH hospital treatment (bed, consultation fees, and medications)
-
(4)
Family travel costs = actual cost of bus fare, taxi, or mileage to visit hospitals (SH or non-SH) or outpatient service (SH service or non-SH) because of the child’s illness
-
(5)
Family “other related” costs = actual for food supplements and nonprescription remedies + actual costs for additional day care + actual cost for extra diaper use + actual costs for miscellaneous items (families were shown how to record these various costs in the symptom diary at the time of recruitment)
-
(6)
Total indirect costs were calculated as the mother’s time cost + father’s time cost + other’s time cost, where mother’s time cost = (hour/day off work) (mother’s estimated hour/day salary); and father’s time cost = (hour/day off work) (father’s estimated hour/day salary); and other’s time cost = (hour/day off work) (other’s estimated hour/day salary). Parents were asked to record in the symptom diary all time taken off from paid employment
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Chen, KT. (2010). The Economic Burden of Rotavirus Diarrhea: Taiwan Perspectives. In: Preedy, V.R., Watson, R.R. (eds) Handbook of Disease Burdens and Quality of Life Measures. Springer, New York, NY. https://doi.org/10.1007/978-0-387-78665-0_71
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