期刊名称：The Journal of Health, Population and Nutrition
印刷版ISSN：1606-0997
电子版ISSN：2072-1315
出版年度：2004
卷号：22
期号：3
页码：311-321
出版社：International Centre for Diarrhoeal Disease Research Bangladesh
摘要：Many economic analyses of immunization programmes focus on the benefits in terms of public-sector cost savings, but do not incorporate estimates of the private cost savings that individuals receive from vaccination. This paper considers the implications of Bahl et al .'s cost-of-illness estimates for typhoid immunization policy by examining how community-level incidence estimates and information on distribution of costs of illness among patients and the public-health sector can be used in the economic analysis of vaccination-programme options. The findings illustrate why typhoid vaccination programmes may often appear to be unattractive to public-health officials who adopt a public budgetary perspective. Under many plausible sets of assumptions, public-sector expenditure on typhoid vaccination does not yield comparable public-sector cost savings. If public-health officials adopt a societal perspective on the economic benefits of vaccination, there are many situations in which different vaccination programmes will make economic sense. The findings show that this is especially true when public decision-makers recognize that (a) the incidence of typhoid fever is underestimated by blood culture-positive cases and (b) avoided costs of illness represent a significant underestimate of the actual economic benefits to individuals of vaccination.
关键词：Typhoid fever; Cost-benefit analysis; Costs and cost analysis; Cost of illness; Vaccination; Typhoid-paratyphoid vaccines; Slums; Urban health; India
