The cost-of-illness due to rheumatic heart disease: national estimates for Fiji.

Pacific Islands cost of illness economics rheumatic fever rheumatic heart disease

Journal

Transactions of the Royal Society of Tropical Medicine and Hygiene
ISSN: 1878-3503
Titre abrégé: Trans R Soc Trop Med Hyg
Pays: England
ID NLM: 7506129

Informations de publication

Date de publication:
01 07 2020
Historique:
received: 01 01 2019
revised: 01 01 2019
accepted: 01 01 2019
pubmed: 2 4 2020
medline: 25 6 2021
entrez: 2 4 2020
Statut: ppublish

Résumé

Rheumatic heart disease (RHD) is a chronic valvular heart disease that is responsible for a heavy burden of premature mortality in low- and middle-income countries. The total costs of RHD are important to health policy and research investment decisions. We estimate for the first time the total cost of RHD for Fiji (2008-2012) using a cost-of-illness approach and novel primary data on RHD disease burden and costs. RHD cases were identified using probabilistic record linkage across four routine data sources: (1) the Fiji RHD Control Program, (2) national hospital admissions records, (3) the Ministry of Health database of cause-specific deaths and (4) hospital ECG clinic registers. For each individual with RHD, we obtained information on RHD hospital admissions, treatment and death. We conducted a prevalence-based cost-of-illness analysis, including bottom-up assessment of indirect and direct (healthcare) costs. The estimated cost of RHD in Fiji for 2008-2012 was year-2010 $FJ91.6 million (approximately US$47.7 million). Productivity losses from premature mortality constituted the majority of costs (71.4%). Indirect costs were 27-fold larger than the direct costs. RHD leads to a heavy economic burden in Fiji. Improved prevention strategies for RHD will likely confer substantial economic benefits to the country.

Sections du résumé

BACKGROUND
Rheumatic heart disease (RHD) is a chronic valvular heart disease that is responsible for a heavy burden of premature mortality in low- and middle-income countries. The total costs of RHD are important to health policy and research investment decisions. We estimate for the first time the total cost of RHD for Fiji (2008-2012) using a cost-of-illness approach and novel primary data on RHD disease burden and costs.
METHODS
RHD cases were identified using probabilistic record linkage across four routine data sources: (1) the Fiji RHD Control Program, (2) national hospital admissions records, (3) the Ministry of Health database of cause-specific deaths and (4) hospital ECG clinic registers. For each individual with RHD, we obtained information on RHD hospital admissions, treatment and death. We conducted a prevalence-based cost-of-illness analysis, including bottom-up assessment of indirect and direct (healthcare) costs.
RESULTS
The estimated cost of RHD in Fiji for 2008-2012 was year-2010 $FJ91.6 million (approximately US$47.7 million). Productivity losses from premature mortality constituted the majority of costs (71.4%). Indirect costs were 27-fold larger than the direct costs.
CONCLUSIONS
RHD leads to a heavy economic burden in Fiji. Improved prevention strategies for RHD will likely confer substantial economic benefits to the country.

Identifiants

pubmed: 32232393
pii: 5813909
doi: 10.1093/trstmh/trz118
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

483-491

Informations de copyright

© The Author(s) 2020. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.

Auteurs

Rachel C Heenan (RC)

Centre for International Child Health, University of Melbourne, Royal Children's Hospital, Parkville 3052, Australia.
Department of General Medicine, Royal Children's Hospital Melbourne, Parkville 3052, Australia.

Tom Parks (T)

Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London WC1E 7HT, UK.
Wellcome Centre for Human Genetics, University of Oxford, Churchill Hospital, Oxford OX3 7LE, UK.

Till Bärnighausen (T)

Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston 02115, USA.
Africa Health Research Institute, KwaZulu-Natal 4013, South Africa.
Institute of Public Health, Heidelberg University, Heidelberg 69120, Germany.

Joseph Kado (J)

College of Medicine, Nursing and Health Sciences, Fiji National University, Suva, Fiji.
Telethon Kids Institute, Nedlands 6009, Australia.

David E Bloom (DE)

Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston 02115, USA.

Andrew C Steer (AC)

Centre for International Child Health, University of Melbourne, Royal Children's Hospital, Parkville 3052, Australia.
Department of General Medicine, Royal Children's Hospital Melbourne, Parkville 3052, Australia.
Tropical Diseases Research Group, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville 3052, Australia.

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