A preliminary analysis of the possible influence of H5N1 influenza outbreak on medical utilization - Experience from SARS outbreaks

Objectives: This study calculated the hospital admission expenditures required for responding to different attack rates of pandemic H5N1 influenza, and explored the factors related to medical utilization that were required during Severe Acute Respiratory Syndrome (SARS) outbreaks. Methods: Records retrieved from the National Health Insurance (NHI) database developed by the National Health Research Institution (NHRI) showed that there were 366 inpatients with SARS in 2003. The data were analyzed using inferential statistical techniques, including the independent t-test, χ2-test, ANOVA and linear regression. Results: The findings revealed that for attack rates of 15%, 25% and 35%, the estimated admission expenditures were the highest when considering in-hospital death and patient age simultaneously. Total admission expenditures for elderly patients over the age of 65 years were higher than those for other age groups. Secondly, factors that were determined to be related to admission expenditures were patient gender, in-hospital death, hospital level, hospital ownership and length of stay (LOS). Finally, the related factors of LOS were at the hospital level. Conclusions: Total admission expenditures for elderly patients over the age of 65 years were higher than those for other age groups. Hence, we suggest a specific health policy for this group to reduce the risk of disease and medical expenses. Secondly, because admission expenditures were highest in local hospitals and lowest in regional hospitals, we suggest that regional hospitals be given priority if health authorities designate exclusive hospitals for treating H5N1 influenza.