Study on the economic burden of hospital-acquired influenza patients_West China Medical Journal

Authors：

WANG Xue ^1,2,3 ,  LEI Na ² , ZENG Qinghui ² , HUANG Wenzhi ² , SHI Wu ² , QIAO Fu ²

1. Center for Infectious Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Hospital Infection Management, West China Hospital, Chengdu, Sichuan 610041, P. R. China;
3. University West China School of Public Health / West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

LEI Na, Email: 182329267@qq.com

Keywords：

Hospital-acquired influenza; influenza; economic burden

DOI：

10.7507/1002-0179.202601133

Video：

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Objective To investigate the epidemiological characteristics and disease burden of hospital-acquired influenza. Methods Medical records of inpatients admitted to West China Hospital, Sichuan University from 2020 to 2023 were retrospectively collected to analyze the three-distribution (temporal, spatial and population). Propensity score matching combined with generalized linear model were adopted to compare the differences in length of hospital stay and various medical expenses between the hospital-acquired influenza group and the control group, so as to explore the impacts of hospital-acquired influenza on the length of hospital stay and medical costs of inpatients. Results A total of 970 366 hospitalized patients were included, among whom 588 hospitalized influenza cases were enrolled, including 175 cases of hospital-acquired influenza and 413 cases of community-acquired influenza. A control group of 175 cases was matched using propensity score matching. The hospitalization duration [19.00 (13.00, 35.00) vs. 10.00 (6.00, 16.50) days, P<0.001] and total medical expenses [34 764.13 (17 851.96, 110 687.64) vs. 14 769.48 (8 028.96, 37 123.71) yuan, P<0.001] of hospital-acquired influenza patients were higher than those of the control group. The results of the generalized linear models showed that hospital-acquired influenza could prolong hospitalization duration (P<0.001) and increase total hospitalization costs (P<0.001). Conclusions Hospital-acquired influenza significantly prolongs the length of hospital stay and increases medical expenditures of inpatients, which greatly aggravates the disease burden of patients and medical institutions. Therefore, medical institutions should attach importance to the prevention and control of influenza virus in hospitals to reduce the incidence of hospital-acquired influenza.

Citation： WANG Xue, LEI Na, ZENG Qinghui, HUANG Wenzhi, SHI Wu, QIAO Fu. Study on the economic burden of hospital-acquired influenza patients. West China Medical Journal, 2026, 41(3): 429-434. doi: 10.7507/1002-0179.202601133 Copy

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2.	Karve S, Misurski D, Herrera-Taracena G, et al. Annual all-cause healthcare costs among influenza patients with and without influenza-related complications: analysis of a United States managed care database. Appl Health Econ Health Policy, 2013, 11(2): 119-128.
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11.	álvarez-Lerma F, Marín-Corral J, Vilà C, et al. Characteristics of patients with hospital-acquired influenza A (H1N1) pdm09 virus admitted to the intensive care unit. J Hosp Infect, 2017, 95(2):200-206.
12.	Huzly D, Kurz S, Ebner W, et al. Characterisation of nosocomial and community-acquired influenza in a large university hospital during two consecutive influenza seasons. J Clin Virol, 2015, 73: 47-51.
13.	Chen H, Liu S, Liu J, et al. Nosocomial co-transmission of avian influenza A(H7N9) and A(H1N1) pdm09 viruses between 2 patients with hematologic disorders. Emerg Infect Dis, 2016, 22(4): 598-607.
14.	Mangas-MoroA, Zamarrón-de-Lucas E, Carpio-Segura CJ, et al. Impact and characteristics of hospital-acquired influenza over 10 seasons in a third-level university hospital. Enferm Infecc Microbiol Clin (Engl Ed), 2023, 41(7): 391-395.
15.	中華人民共和國國家統計局. 中國統計年鑒(2022-2024). 北京: 中國統計出版社, 2024.
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19.	Van Voris LP, Belshe RB, Shaffer JL. Nosocomial influenza B virus infection in the elderly. Ann Intern Med, 1982, 96(2): 153-158.
20.	Sartor C, Zandotti C, Romain F, et al. Disruption of services in an internal medicine unit due to a nosocomial influenza outbreak. Infect Control Hosp Epidemiol, 2002, 23(10): 615-619.

1. Javanian M, Barary M, Ghebrehewet S, et al. A brief review of influenza virus infection. J Med Virol, 2021, 93(8): 4638-4646.
2. Karve S, Misurski D, Herrera-Taracena G, et al. Annual all-cause healthcare costs among influenza patients with and without influenza-related complications: analysis of a United States managed care database. Appl Health Econ Health Policy, 2013, 11(2): 119-128.
3. Naudion P, Lepiller Q, Bouiller K. Risk factors and clinical characteristics of patients with nosocomial influenza A infection.J Med Virol, 2020, 92(8): 1047-1052.
4. Njouom R, Monamele GC, Ermetal B, et al. Detection of influenza C virus infection among hospitalized patients, Cameroon. Emerg Infect Dis, 2019, 25(3): 607-609.
5. Salgado CD, Farr BM, Hall KK, et al. Influenza in the acute hospital setting. Lancet Infect Dis, 2002, 2(3): 145-155.
6. 張云飛, 李超, 任瑞琦, 等. 2004-2017 年全國醫院感染引起的突發公共衛生事件流行特征分析. 疾病監測, 2020, 35(2): 162-166.
7. Goody P, Torner N, Soldevila N, et al. Hospital-acquired influenza infections detected by a surveillance system over six seasons, from 2010/2011 to 2015/2016. BMC Infect Dis, 2020, 20(1): 80.
8. 趙嵐, 干鐵兒, 陳愛鳳, 等. 醫院獲得性流感監測及其飛沫預防實踐進展. 中華醫院感染學雜志, 2023, 33(22): 3505-3510.
9. Parkash N, Beckingham W, Andersson P, et al. Hospital-acquired influenza in an Australian tertiary centre 2017: a surveillance based study. BMC Pulm Med, 2019, 19(1): 79.
10. Bilgin H, Ba?ar? T, Pazar N, et al. Comparison of 28-day mortality between hospital- and community-acquired influenza patients. Infect Dis Clin Microbiol, 2023, 5(3): 231-238.
11. álvarez-Lerma F, Marín-Corral J, Vilà C, et al. Characteristics of patients with hospital-acquired influenza A (H1N1) pdm09 virus admitted to the intensive care unit. J Hosp Infect, 2017, 95(2):200-206.
12. Huzly D, Kurz S, Ebner W, et al. Characterisation of nosocomial and community-acquired influenza in a large university hospital during two consecutive influenza seasons. J Clin Virol, 2015, 73: 47-51.
13. Chen H, Liu S, Liu J, et al. Nosocomial co-transmission of avian influenza A(H7N9) and A(H1N1) pdm09 viruses between 2 patients with hematologic disorders. Emerg Infect Dis, 2016, 22(4): 598-607.
14. Mangas-MoroA, Zamarrón-de-Lucas E, Carpio-Segura CJ, et al. Impact and characteristics of hospital-acquired influenza over 10 seasons in a third-level university hospital. Enferm Infecc Microbiol Clin (Engl Ed), 2023, 41(7): 391-395.
15. 中華人民共和國國家統計局. 中國統計年鑒(2022-2024). 北京: 中國統計出版社, 2024.
16. Pagani L, Thomas Y, Huttner B, et al. Transmission and effect of multiple clusters of seasonal influenza in a Swiss geriatric hospital. J Am Geriatr Soc, 2015, 63(4): 739-744.
17. Sagrera X, Ginovart G, Raspall F, et al. Outbreaks of influenza A virus infection in neonatal intensive care units. Pediatr Infect Dis J, 2002, 21(3): 196-200.
18. Kim H, Webster RG, Webby RJ. Influenza virus: dealing with a drifting and shifting pathogen. Viral Immunol, 2018, 31(2): 174-183.
19. Van Voris LP, Belshe RB, Shaffer JL. Nosocomial influenza B virus infection in the elderly. Ann Intern Med, 1982, 96(2): 153-158.
20. Sartor C, Zandotti C, Romain F, et al. Disruption of services in an internal medicine unit due to a nosocomial influenza outbreak. Infect Control Hosp Epidemiol, 2002, 23(10): 615-619.

West China Medical Journal

Study on the economic burden of hospital-acquired influenza patients

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