Costs associated with acute respiratory illness and select virus infections in hospitalized children, El Salvador and Panama, 2012-2013.


Journal

The Journal of infection
ISSN: 1532-2742
Titre abrégé: J Infect
Pays: England
ID NLM: 7908424

Informations de publication

Date de publication:
08 2019
Historique:
received: 04 01 2019
revised: 22 05 2019
accepted: 29 05 2019
pubmed: 4 6 2019
medline: 14 7 2020
entrez: 3 6 2019
Statut: ppublish

Résumé

Although acute respiratory illness (ARI) is a leading cause of hospitalization among young children, few data are available about cost of hospitalization in middle-income countries. We estimated direct and indirect costs associated with severe ARI resulting in hospitalization among children aged <10 years in El Salvador and Panama through the societal perspective. During 2012 and 2013, we surveyed caregivers of children hospitalized with ARI about their direct medical (i.e., outpatient consultation, medications, hospital fees), non-medical (transportation, childcare), and indirect costs (lost wages) at discharge and 7 days after discharge. We multiplied subsidized hospital bed costs derived from administrative data by hospitalization days to estimate provider costs. Overall, 638 children were enrolled with a median age of 12 months (IQR 6-23). Their median length of hospitalization was 4 days (IQR 3-6). In El Salvador, caregivers incurred a median of US$38 (IQR 22-72) in direct and indirect costs per illness episode, while the median government-paid hospitalization cost was US$118 (IQR 59-384) generating an overall societal cost of US$219 (IQR 101-416) per severe ARI episode. In Panama, caregivers incurred a median of US$75 (IQR 39-135) in direct and indirect costs, and the health-care system paid US$280 (IQR 150-420) per hospitalization producing an overall societal cost of US$393 (IQR 258-552). The cost of severe ARI to caregivers and the health care system was substantive. Our estimates will inform models to estimate national costs of severe ARI and cost-benefit of prevention and treatment strategies.

Sections du résumé

BACKGROUND AND OBJECTIVES
Although acute respiratory illness (ARI) is a leading cause of hospitalization among young children, few data are available about cost of hospitalization in middle-income countries. We estimated direct and indirect costs associated with severe ARI resulting in hospitalization among children aged <10 years in El Salvador and Panama through the societal perspective.
METHODS
During 2012 and 2013, we surveyed caregivers of children hospitalized with ARI about their direct medical (i.e., outpatient consultation, medications, hospital fees), non-medical (transportation, childcare), and indirect costs (lost wages) at discharge and 7 days after discharge. We multiplied subsidized hospital bed costs derived from administrative data by hospitalization days to estimate provider costs.
RESULTS
Overall, 638 children were enrolled with a median age of 12 months (IQR 6-23). Their median length of hospitalization was 4 days (IQR 3-6). In El Salvador, caregivers incurred a median of US$38 (IQR 22-72) in direct and indirect costs per illness episode, while the median government-paid hospitalization cost was US$118 (IQR 59-384) generating an overall societal cost of US$219 (IQR 101-416) per severe ARI episode. In Panama, caregivers incurred a median of US$75 (IQR 39-135) in direct and indirect costs, and the health-care system paid US$280 (IQR 150-420) per hospitalization producing an overall societal cost of US$393 (IQR 258-552).
CONCLUSIONS
The cost of severe ARI to caregivers and the health care system was substantive. Our estimates will inform models to estimate national costs of severe ARI and cost-benefit of prevention and treatment strategies.

Identifiants

pubmed: 31153920
pii: S0163-4453(19)30180-X
doi: 10.1016/j.jinf.2019.05.021
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT01690637']

Types de publication

Journal Article Research Support, U.S. Gov't, P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

108-114

Subventions

Organisme : CDC HHS
Pays : United States

Informations de copyright

Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.

Auteurs

Jorge H Jara (JH)

Centro de Estudios en Salud, Universidad del Valle de Guatemala, 18 Avenida 11-95 Zona 15, Vista Hermosa III, Guatemala City, 01015, Guatemala. Electronic address: jjara@ces.uvg.edu.gt.

Eduardo Azziz-Baumgartner (E)

Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.

Tirza De Leon (T)

Hospital Materno Infantil José Domingo De Obaldía, David, Panama.

Kathia Luciani (K)

Hospital De Especialidades Pediátricas Omar Torrijos, Panama City, Panama.

Yarisa Sujey Brizuela (YS)

Hospital San Juan De Dios, San Miguel, El Salvador.

Dora Estripeaut (D)

Hospital Del Niño, Panama City, Panama.

Juan Miguel Castillo (JM)

Hospital San Juan De Dios, Santa Ana, El Salvador.

Alfredo Barahona (A)

Hospital Materno Infantil José Domingo De Obaldía, David, Panama.

Mary Corro (M)

Hospital De Especialidades Pediátricas Omar Torrijos, Panama City, Panama.

Rafael Cazares (R)

Hospital San Juan De Dios, San Miguel, El Salvador.

Ofelina Vergara (O)

Hospital Del Niño, Panama City, Panama.

Rafael Rauda (R)

Hospital San Juan De Dios, Santa Ana, El Salvador.

Rosalba González (R)

Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama.

Danilo Franco (D)

Instituto Conmemorativo Gorgas de Estudios de la Salud, Panama City, Panama.

Marc-Alain Widdowson (MA)

Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.

Wilfrido Clará (W)

Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.

Juan P Alvis-Estrada (JP)

Centro de Estudios en Salud, Universidad del Valle de Guatemala, 18 Avenida 11-95 Zona 15, Vista Hermosa III, Guatemala City, 01015, Guatemala.

Christian Travis Murray (CT)

Centro de Estudios en Salud, Universidad del Valle de Guatemala, 18 Avenida 11-95 Zona 15, Vista Hermosa III, Guatemala City, 01015, Guatemala.

Ismael R Ortega-Sanchez (IR)

Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.

Fatimah S Dawood (FS)

Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, USA.

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