{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T20:20:28Z","timestamp":1780086028101,"version":"3.54.0"},"reference-count":31,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2021,5,13]],"date-time":"2021-05-13T00:00:00Z","timestamp":1620864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Introduction: Influenza infection is associated with potential serious complications, increased hospitalization rates, and a higher risk of death. Materials and Methods: A retrospective comparative analysis of selected indicators of hospitalization from the University Hospital in Wroclaw, Poland, was carried out on patients with confirmed influenza infection in comparison to a control group randomly selected from among all other patients hospitalized on the respective wards during the 2018\u20132019 influenza season. Results: The mean laboratory testing costs for the entire hospital were 3.74-fold higher and the mean imaging test costs were 4.02-fold higher for patients with confirmed influenza than for the control group; the hospital expenses were additionally raised by the cost of antiviral therapy, which is striking when compared against the cost of a single flu vaccine. During the 2018\u20132019 influenza season, influenza infections among the hospital patients temporarily limited the healthcare service availability in the institution, which resulted in reduced admission rates to the departments related to internal medicine; the mean absence among the hospital staff totaled approximately 7 h per employee, despite 7.3% of the staff having been vaccinated against influenza at the hospital\u2019s expense. Conclusions: There were significant differences in the hospitalization indicators between the patients with confirmed influenza and the control group, which markedly increased the hospital care costs in this multi-specialty university hospital.<\/jats:p>","DOI":"10.3390\/ijerph18105173","type":"journal-article","created":{"date-parts":[[2021,5,13]],"date-time":"2021-05-13T11:10:06Z","timestamp":1620904206000},"page":"5173","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Seasonal Influenza and Low Flu Vaccination Coverage as Important Factors Modifying the Costs and Availability of Hospital Services in Poland: A Retrospective Comparative Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2680-7617","authenticated-orcid":false,"given":"Robert","family":"Sus\u0142o","sequence":"first","affiliation":[{"name":"Gerontology Unit, Public Health Department, Wroclaw Medical University, 51-618 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9216-451X","authenticated-orcid":false,"given":"Piotr","family":"Pobrotyn","sequence":"additional","affiliation":[{"name":"University Clinical Hospital Management, Wroclaw Medical University, 50-560 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0553-627X","authenticated-orcid":false,"given":"Lidia","family":"Brydak","sequence":"additional","affiliation":[{"name":"National Institute of Public Health National Institute of Hygiene, 00-791 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5847-6579","authenticated-orcid":false,"given":"\u0141ukasz","family":"Rypicz","sequence":"additional","affiliation":[{"name":"Economics and Quality in Healthcare Unit, Public Health Department, Wroclaw Medical University, 51-618 Wroc\u0142aw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3783-0481","authenticated-orcid":false,"given":"Urszula","family":"Grata-Borkowska","sequence":"additional","affiliation":[{"name":"Family Medicine Unit, Family Medicine Department, Wroclaw Medical University, 51-141 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5472-1485","authenticated-orcid":false,"given":"Jaros\u0142aw","family":"Drobnik","sequence":"additional","affiliation":[{"name":"Gerontology Unit, Public Health Department, Wroclaw Medical University, 51-618 Wroclaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,5,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1016\/j.amjmed.2007.10.040","article-title":"Complications of Viral Influenza","volume":"121","author":"Rothberg","year":"2008","journal-title":"Am. J. Med."},{"key":"ref_2","first-page":"428","article-title":"Medical and economic burden of influenza in the elderly population in central and eastern European countries","volume":"10","author":"Kyncl","year":"2013","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1080\/20786204.2013.10874372","article-title":"Colds, flu and coughing: A review of over-the-counter cold and flu medicines","volume":"55","year":"2013","journal-title":"S. Afr. Fam. Pr."},{"key":"ref_4","unstructured":"Brydak, L. (2008). Leki Antygrypowe. Grypa, Pandemia Grypy Mit Czy Realne Zagro\u017cenie?, Wydawnictwo RYTM. [3rd ed.]."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1711","DOI":"10.1080\/14656566.2019.1626824","article-title":"Neuraminidase inhibitors as a strategy for influenza treatment: Pros, cons and future perspectives","volume":"20","author":"Bassetti","year":"2019","journal-title":"Expert Opin. Pharmacother."},{"key":"ref_6","first-page":"162","article-title":"Profilaktyka i leczenie u dzieci i m\u0142odzie\u017cy","volume":"16","author":"Brydak","year":"2019","journal-title":"Stand. Med. Pediatr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1080\/21645515.2017.1264829","article-title":"The Working Group of the Project PI12\/02079 Costs associated with influenza-related hospitalization in the elderly","volume":"13","author":"Torner","year":"2016","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"947","DOI":"10.7326\/0003-4819-121-12-199412150-00008","article-title":"Influenza Vaccination Programs for Elderly Persons: Cost-Effectiveness in a Health Maintenance Organization","volume":"121","author":"Mullooly","year":"1994","journal-title":"Ann. Intern. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1159\/000213802","article-title":"Influenza Vaccination for All Elderly","volume":"42","author":"Wijma","year":"1996","journal-title":"Gerontology"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Ganczak, M., Gil, K., Korze\u0144, M., and Ba\u017cyd\u0142o, M. (2017). Coverage and Influencing Determinants of Influenza Vaccination in Elderly Patients in a Country with a Poor Vaccination Implementation. Int. J. Environ. Res. Public Health, 14.","DOI":"10.3390\/ijerph14060665"},{"key":"ref_11","unstructured":"Brydak, L. (2019, October 30). Ile Os\u00f3b Zaszczepi\u0142o Si\u0119 Przeciw Grypie w Sezonie 2018\/2019? PZH-NIZP. Szczepienia Info, Available online: http:\/\/szczepienia.pzh.gov.pl\/szczepionki\/grypa\/10\/#ile-osob-zaszczepilo-sie-przeciw-grypie-w-sezonie-2018\/2019."},{"key":"ref_12","unstructured":"European Centre for Disease Prevention and Control (2021, March 22). Seasonal Influenza Vaccination and Antiviral Use in EU\/EEA Member States Overview of Vaccine Recommendations for 2017\u20132018 and Vaccination Coverage Rates for 2015\u20132016 and 2016\u20132017 Influenza Seasons. ECDC 2018. Available online: https:\/\/www.ecdc.europa.eu\/sites\/default\/files\/documents\/seasonal-influenza-antiviral-use-2018.pdf."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"389","DOI":"10.5114\/fmpcr.2018.80081","article-title":"Conflict of individual freedom and community health safety: Legal conditions on mandatory vaccinations and changes in the judicial approach in the case of avoidance","volume":"20","author":"Paplicki","year":"2018","journal-title":"Fam. Med. Prim. Care Rev."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Gianino, M.M., Politano, G., Scarmozzino, A., Stillo, M., Amprino, V., Di Carlo, S., Benso, A., and Zotti, C.M. (2019). Cost of Sickness Absenteeism during Seasonal Influenza Outbreaks of Medium Intensity among Health Care Workers. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16050747"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1001\/jama.281.10.908","article-title":"Effectiveness of Influenza Vaccine in Health Care Professionals","volume":"281","author":"Wilde","year":"1999","journal-title":"JAMA"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"24","DOI":"10.2105\/AJPH.2008.136440","article-title":"Requiring Influenza Vaccination for Health Care Workers","volume":"99","author":"Anikeeva","year":"2009","journal-title":"Am. J. Public Health"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"17","DOI":"10.2807\/1560-7917.ES.2018.23.16.17-00454","article-title":"Impact of infectious diseases on population health using incidence-based disability-adjusted life years (DALYs): Results from the Burden of Communicable Diseases in Europe study, European Union and European Economic Area countries, 2009 to 2013","volume":"23","author":"Cassini","year":"2018","journal-title":"Eurosurveillance"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s10198-020-01172-1","article-title":"Incidence and costs of hospitalized adult influenza patients in The Netherlands: A retrospective observational study","volume":"21","author":"Marbus","year":"2020","journal-title":"Eur. J. Health Econ."},{"key":"ref_19","unstructured":"(2019, October 27). Szczepionka Przeciw Grypie Dro\u017csza, bo Znalaz\u0142a si\u0119 na Li\u015bcie Lek\u00f3w Refundowanych? Gazeta Wyborcza\u2014Rynek Zdrowia 26 July 2018. Available online: http:\/\/www.rynekzdrowia.pl\/Serwis-Szczepienia\/Szczepionka-przeciw-grypie-drozsza-bo-znalazla-sie-na-liscie-lekow-refundowanych,186139,1018.html."},{"key":"ref_20","first-page":"98","article-title":"Grypa u Ci\u0119\u017carnych\u2014Leczenie i Profilaktyka","volume":"19","author":"Szenborn","year":"2010","journal-title":"Medycyna Dyplomie"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Matsuoka, T., Sato, T., Akita, T., Yanagida, J., Ohge, H., Kuwabara, M., and Tanaka, J. (2016). High Vaccination Coverage among Children during Influenza A(H1N1)pdm09 as a Potential Factor of Herd Immunity. Int. J. Environ. Res. Public Health, 13.","DOI":"10.3390\/ijerph13101017"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Suphanchaimat, R., Doung-Ngern, P., Ploddi, K., Suthachana, S., Phaiyarom, M., Pachanee, K., Chaifoo, W., and Iamsirithaworn, S. (2020). Cost Effectiveness and Budget Impact Analyses of Influenza Vaccination for Prisoners in Thailand: An Application of System Dynamic Modelling. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17041247"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"9750","DOI":"10.3390\/ijerph120809750","article-title":"Assessing the Role of Voluntary Self-Isolation in the Control of Pandemic Influenza Using a Household Epidemic Model","volume":"12","author":"Zhang","year":"2015","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Moretti, F., Visentin, D., Bovolenta, E., Rimondini, M., Majori, S., Mazzi, M., Poli, A., Tardivo, S., and Torri, E. (2020). Attitudes of Nursing Home Staff towards Influenza Vaccination: Opinions and Factors Influencing Hesitancy. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17061851"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Czajka, H., Czajka, S., Bi\u0142as, P., Pa\u0142ka, P., J\u0119drusik, S., and Czapkiewicz, A. (2020). Who or What Influences the Individuals\u2019 Decision-Making Process Regarding Vaccinations?. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17124461"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Ka\u0142ucka, S., G\u0142owacka, A., Dziankowska-Zaborszczyk, E., and Grzegorczyk-Karolak, I. (2021). Knowledge, Beliefs and Attitudes towards the Influenza Vaccine among Future Healthcare Workers in Poland. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18042105"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Rostkowska, O., Peters, A., Montvidas, J., Magdas, T., Rensen, L., Zgliczy\u0144ski, W., Durlik, M., and Pelzer, B. (2021). Attitudes and Knowledge of European Medical Students and Early Graduates about Vaccination and Self-Reported Vaccination Coverage\u2014Multinational Cross-Sectional Survey. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18073595"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Van Hooste, W.L.C., and Bekaert, M. (2019). To Be or Not to Be Vaccinated? The Ethical Aspects of Influenza Vaccination among Healthcare Workers. Int. J. Environ. Res. Public Health, 16.","DOI":"10.3390\/ijerph16203981"},{"key":"ref_29","unstructured":"Zak\u0142ad Ubezpiecze\u0144 Spo\u0142ecznych\u2014Departament Statystyki i Prognoz Aktuarialnych (2021, March 10). Absencja Chorobowa w 2019 roku. ZUS Warszawa 2020, Available online: https:\/\/www.zus.pl\/documents\/10182\/39590\/Absencja+chorobowa+w+2019+roku.pdf."},{"key":"ref_30","unstructured":"Piorun, M. (2021, March 10). Grypa w Polsce: 3,5 Mln Zachorowa\u0144 od Pocz\u0105tku Sezonu. Stronazdrowia.pl 28.03.2019. Available online: https:\/\/stronazdrowia.pl\/grypa-w-polsce-35-mln-zachorowan-od-poczatku-sezonu-nowe-dane\/ar\/c14-14004223."},{"key":"ref_31","unstructured":"(2021, March 10). Minimalna Stawka Godzinowa 2019. Infor.pl 26.09.2018. Available online: https:\/\/kadry.infor.pl\/kadry\/wynagrodzenia\/wynagrodzenie-minimalne\/2758948,Minimalna-stawka-godzinowa-2019.html."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/10\/5173\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:00:16Z","timestamp":1760162416000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/10\/5173"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5,13]]},"references-count":31,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021,5]]}},"alternative-id":["ijerph18105173"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18105173","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5,13]]}}}