Využití dat ze systému Epi-Dat pro výpočty zatížení onemocněním na příkladu gastroenteritidy

Abstract

Výpočet zátěže či břemena onemocnění - GBD slouží nejen ke komplexnímu posouzení zátěže onemocněním, ale i podaní informací o onemocnění, jejich výskytu, příčinách a důsledcích, určení jejich trendu, které povedou k analýze nákladů a efektivnosti daného onemocnění, či intervencí.

The calculation of GBD - the load or burden of disease is not only a comprehensive assessment of burden of disease, but also provides information on the disease, its occurrences, causes and consequences, to determine their habits that will lead to the analysis of cost-effectiveness of the disease or intervention. The main objective of this work was to create a modeling methodology and the calculation of the burden of disease using data from Epi-data. Other goals and objectives included the theoretical treatment of Epi-Dat, Epi-Info and TESS, analysing the methodology used by the WHO when calculating the burden of disease using DALYs units, suggesting the possibility of estimating the economic burden. The methodology involves the developing of demographic data in the region of - Prague 6 (112 632 inhabitants), including the indicators for the description of the population, the selection of pathogens (Salmonella - 98 persons and Campylobacter - 168 persons), the identification of epidemiological data (mortality, occurrence, lethality, hospitalization, duration of disease ), the cost of disease from the view of the payer, creating sets of estimates for the given calculations, processing in the DISMOD program and calculating with DALYs in the European program called BCoDE and statistical R, the one-way sensitivity analysis. The costs of the illness from the perspective of the payer were calculated as a total cost of treatment by practitioners for selected diseases resulted in CZK 280 591,04. Expenses for hospitalization at another department amounted to CZK 245 555,9 overall. The total costs for the hospitalisation in the department of infectious diseases amounted to CZK 386 195,6. The total costs for both illnesses were 912 342,6 CZK in Prague 6 in 2015. The total DALY in Prague 6 was 21,39 with the BCoDE program (discounting 3 % of 15,79 DALY) and 10 with the R program (discounting 3 % of 4 DALY ). DALY per case is 0,03 with the BCoDE program and 0,04 with the R program. In our work there is a given BCoDE of data before the adjustment of 3,96 DALY, and R after you insert data from DISMOD 13 DALY. When converted to ascertain the costs, the amount for one DALY (the main results) ranges from 42 652,76 to 91 234,26 CZK. The methodology for calculating the burden of disease, which is based on policy guidance from WHO, has been developed in this work. It features an overview and data sources for the given issue that has already been transferred to the Czech Republic, working with the program DISMOD, furthermore, the calculation has been developped in the program BCoDE and statistical R.