title: Economic burden and its associated factors of hospitalized patients infected with A (H7N9) virus: a retrospective study in Eastern China, 2013-2014.
abstract: BACKGROUND
  H7N9 continues to cause human infections and remains a pandemic concern. Understanding the economic impacts of this novel disease is important for making decisions on health resource allocation, including infectious disease prevention and control investment. However, there are limited data on such impacts.
  
  
  METHODS
  Hospitalized laboratory-confirmed H7N9 patients or their families in Jiangsu Province of China were interviewed. Patients' direct medical costs of hospitalization were derived from their hospital bills. A generalized linear model was employed to estimate the mean direct medical costs of patients with different characteristics.
  
  
  RESULTS
  The mean direct cost of hospitalization for H7N9 was estimated to be ¥ 71 060 (95 % CI, 48 180-104 820), i.e., US$ 10 996 (95 % CI, 7 455-16 220), and was ¥12 060 (US$ 1 861), ¥136 120 (US$ 21 001) and ¥218 610 (US$ 33 728) for those who had mild or severe symptoms or who died, respectively. The principal components of the total fees differed among patients with different disease severity, although medication fees were always the largest contributors. Disease severity, proportion of reimbursement and family member monthly average income were identified as the key factors that contributed to a patient's direct medical cost of hospitalization.
  
  
  CONCLUSIONS
  The direct medical costs of hospitalized patients with H7N9 are significant, and far surpass the annual per capita income of Jiangsu Province, China. The influencing factors identified should be taken into account when developing related health insurance policies and making health resource allocation.
  
  
  BACKGROUND
  Not applicable. This is a survey study with no health care intervention implemented on human participants.
authors: Department of Acute Infectious Disease, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiang-su Rd, Nanjing, 210009, China.
authors: Xiang
authors: X
authors: Huo
authors: Suzhou Center for Disease Prevention and Control, Suzhou, China.
authors: Li-Ling
authors: LL
authors: Chen
authors: Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China.
authors: Lei
authors: L
authors: Hong
authors: Baoshan District Center for Disease Control and Prevention, Shanghai, China.
authors: Lun-Hui
authors: LH
authors: Xiang
authors: Department of Acute Infectious Disease, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiang-su Rd, Nanjing, 210009, China.
authors: Fen-Yang
authors: FY
authors: Tang
authors: Wuxi Center for Disease Control and Prevention, Wuxi, China.
authors: Shan-Hui
authors: SH
authors: Chen
authors: Huaian Center for Disease Control and Prevention, Huaian, China.
authors: Qiang
authors: Q
authors: Gao
authors: Changzhou Center for Disease Control and Prevention, Changzhou, China.
authors: Cong
authors: C
authors: Chen
authors: Department of Acute Infectious Disease, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiang-su Rd, Nanjing, 210009, China.
authors: Qi-Gang
authors: QG
authors: Dai
authors: Xuzhou Center for Disease Control and Prevention, Xuzhou, China.
authors: Chuan-Wu
authors: CW
authors: Sun
authors: Department of Acute Infectious Disease, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiang-su Rd, Nanjing, 210009, China.
authors: Ke
authors: K
authors: Xu
authors: Taizhou Center for Disease Control and Prevention, Taizhou, China.
authors: Wen-Jun
authors: WJ
authors: Dai
authors: Department of Acute Infectious Disease, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiang-su Rd, Nanjing, 210009, China.
authors: Xian
authors: X
authors: Qi
authors: Yancheng Center for Disease Control and Prevention, Yancheng, China.
authors: Chang-Cheng
authors: CC
authors: Li
authors: Department of Acute Infectious Disease, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiang-su Rd, Nanjing, 210009, China.
authors: Hui-Yan
authors: HY
authors: Yu
authors: Zhenjiang Center for Disease Prevention and Control, Zhenjiang, China.
authors: Yin
authors: Y
authors: Zhou
authors: Department of Acute Infectious Disease, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiang-su Rd, Nanjing, 210009, China.
authors: Hao-Di
authors: HD
authors: Huang
authors: Yangzhou Center for Disease Control and Prevention, Yangzhou, China.
authors: Xing-Yang
authors: XY
authors: Pan
authors: Suqian Municipal Center for Disease Control and Prevention, Suqian, China.
authors: Chang-Sha
authors: CS
authors: Xu
authors: Department of Acute Infectious Disease, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiang-su Rd, Nanjing, 210009, China.
authors: Ming-Hao
authors: MH
authors: Zhou
authors: Department of Acute Infectious Disease, Jiangsu Provincial Center for Disease Control and Prevention, 172 Jiang-su Rd, Nanjing, 210009, China. bao2000_cn@163.com.
authors: Chang-Jun
authors: CJ
authors: Bao
mesh_terms: D000328:Adult; D000368:Aged; D002681:China; D017281:Cost of Illness; D005260:Female; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D064766:Influenza A Virus, H7N9 Subtype / Q000502:physiology*; D007251:Influenza, Human / Q000191:economics* / Q000821:virology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: Avian influenza; Direct medical costs; H7N9; Hospitalization; Human infections