Use of modeling in the study of economic burden of influenza in the elderly population in Central and Eastern European countries

Abstract

The economic burden of the incidence of influenza and ARI requires careful study, since annually about 15% of the world's population suffers from these diseases. In addition, the flu can cause complications that are dangerous to human life and health, especially those at risk. The elderly population belongs precisely to this group, therefore we have chosen to analyze the economic burden of this category of population. According to the international classification, this group of diseases is divided into the following types:
 
 Influenza-like illness (ILI);
 
 – Acute respiratory infection (ARI);
 – Severe acute respiratory infections (SARI);
 – Severe Acute Respiratory Syndrome (SARS).
 The aim of the work was to develop a model for systematization flows of patients and treatment costs in assessing the economic burden of influenza and ARI morbidity in the elderly peoples in Central and Eastern Europe. The model was developed in cooperation with the Syreon Institute, Hungary. The study involved Hungary, Poland, the Czech Republic, Romania, Ukraine and Kazakhstan.
 The structure of the model is based on the assumption of a flow of patients. The principle of the model was as follows: in order to assess the economic burden of the disease in a certain period of time, it is necessary to quantify (1) the number of patients, and (2) the costs of health care and treatment. The cost of treatment is different in each case, patients should be divided into relatively homogeneous groups. Since the quantity and quality of the epidemiological data on influenza and related diseases is rather heterogeneous in different countries, WHO offers certain objects of influenza research, taken as a basis for constructing such a model. According to this classification of influenza and WHO definition, the central structure of our model was formed by acute respiratory infections (ARI), representing outpatient cases and severe acute respiratory infections (SARI), representing inpatient cases.
 The next stage of the research was the study of the cost structure and the principles of collecting expenditure data. The economic burden of influenza in the elderly populations has been analyzed based on the type of health system. In older people, it is difficult to establish a link between influenza and complications of chronic diseases and other acute medical conditions (eg, acute coronary syndrome). This analysis does not include estimates of the economic impact of influenza on other co-morbidities and long-term chronic effects associated with complications of influenza. Since the population of 60+ or 65+ is a risk group and is a numerical group, the cost of treatment in the event of complications and hospitalization will increase cost for the patient and for the medical institution. However, in this case indirect costs is missing, such as paying a sick list. Direct medical cost were subject to analysis. The proposed methodology allows you to objectively assess the costs of treatment and calculate the economic burden, taking into account the type and health system.