Abstract
BackgroundInfluenza causes considerable morbidity and mortality in China, but its impact on the health-related quality of life (HRQoL) has not been previously measured.MethodsWe conducted a retrospective telephone survey to assess the impact of influenza on the HRQoL among outpatients and inpatients using the EuroQoL EQ-5D-3 L instrument. Participants were individuals with laboratory-confirmed influenza infection registered by the National Influenza-like-illness Surveillance Network in 2013.ResultsWe interviewed 839 of 11,098 eligible influenza patients. After excluding those who were unable to complete the HRQoL for the registered influenza episode, 778 patients were included in the analysis. Both outpatients (n = 529) and inpatients (n = 249) most commonly reported problems with pain/discomfort (71.8% of outpatients and 71.9% of inpatients) and anxiety/depression (62.0% of outpatients and 75.1% of inpatients). For individual influenza outpatients, the mean health utility was 0.6142 (SD 0.2006), and the average quality adjusted life days (QALD) loss was 1.62 (SD 1.84) days. The HRQoL of influenza inpatients was worse (mean health utility 0.5851, SD 0.2197; mean QALD loss 3.51 days, SD 4.25) than that of outpatients (p < 0.05). The presence of underlying medical conditions lowered the HRQoL for both outpatients and inpatients (p < 0.05).ConclusionsInfluenza illness had a substantial impact on HRQoL. QALD loss due to an acute influenza episode in younger children was comparable to that due to enterovirus A71-associated hand, foot and mouth disease. Our findings are key inputs into disease burden estimates and cost-effectiveness evaluations of influenza-related interventions in China.
Highlights
Influenza causes considerable morbidity and mortality in China, but its impact on the health-related quality of life (HRQoL) has not been previously measured
A telephone investigation was conducted from 25 December 2013 to 11 January 2014 among influenza patients registered in the National Influenza-likeillness Surveillance Network (ILINet) in China
Characteristics of enrolled patients Of 39,968 laboratory-confirmed influenza patients registered in the National ILINet, 11,098 influenza patients with telephone numbers registered were eligible, and 778 patients who were successfully interviewed (529 outpatients and 249 inpatients) were included in the analysis
Summary
Influenza causes considerable morbidity and mortality in China, but its impact on the health-related quality of life (HRQoL) has not been previously measured. The World Health Organization recommends influenza vaccination for reducing influenza burden [3], but China has yet to Previous reports have estimated influenza incidence and mortality, but none of them have investigated the impact of influenza on health-related quality of life (HRQoL) in China. HRQoL measures such as quality adjusted life years combine measures of morbidity and mortality into a single unit, enabling comparisons between diseases of varying incidence and severity. This information will be useful for parameterizing comparative analysis of interventions for influenza. HRQoL measurements from other countries is unlikely to be directly applicable in China because the utilities associated with different health states are likely to be influenced by cultural perceptions and preferences [7, 8]
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