Direct Medical Cost of Influenza-Related Hospitalizations among Severe Acute Respiratory Infections Cases in Three Provinces in China

Zhou, Lei; Situ, Sujian; Huang, Ting; Hu, Shixiong; Wang, Xianjun; Zhu, Xiaoping; Gao, Lidong; Li, Zhong; Feng, Ao; Jin, Hui; Wang, Shiyuan; Su, Qiru; Xu, Zhihua; Feng, Zijian

doi:10.1371/journal.pone.0063788

Cited by 26 publications

(49 citation statements)

References 11 publications

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“…Our study of the direct medical costs of laboratory-confirmed influenza hospitalizations in patients aged 65 y in Spain found the mean cost per case was € 3,219, higher than the € 2,490 found in Poland, 14 the € 1,570.3 found in China, 27 or the € 1,270€ (in terms of 2011 purchasing power) reported in Italy. 28 The reduction in cost of 2.5% in vaccinated cases in our study came mainly from the reduction in the ICU stay, sparing mechanical ventilation and preventing secondary bacterial pneumonia.…”

Section: Discussioncontrasting

confidence: 52%

Costs associated with influenza-related hospitalization in the elderly

Torner

Navas²,

Soldevila

et al. 2016

Human Vaccines & Immunotherapeutics

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Seasonal influenza epidemics remain a considerable burden in adults, especially in those at higher risk of complications. The aim of this study was to determine the costs associated with influenza-related hospitalization in patients aged 65 y admitted to 20 hospitals from 7 Spanish regions during the 2013-14 and 2014-15 influenza seasons. Bivariate analysis was used to compare costs in vaccinated and unvaccinated cases. Costs were calculated according to the Spanish National Health System diagnosisrelated group tables for influenza and other respiratory system conditions (GRD 89 and GRD 101). A total of 728 confirmed influenza cases were recorded: 52.9% were male, 46.7% were aged 75-84 years, and 49.3% received influenza vaccine 15 d prior to hospital admission. Influenza-related mean hospitalization costs (MHC) were € 1,184,808 in unvaccinated and € 1,152,333 in vaccinated cases (2.75% lower). Influenza vaccination showed significant protection against ICU admission (OR 0.35, 95%CI 0.21-0.59; p < 0001); mechanical ventilation (OR 0.56, 95%CI 0.39-0.80; p D 0.002); secondary bacterial pneumonia (OR 0.61,; p D 0.04) and a higher degree of dependence (OR 0.74, p D 0.04). No association was observed for the Charlson comorbidity index or the mean hospital stay. Although influenza vaccination of the elderly may not achieve significant savings in mean hospitalization costs, it may lessen the degree of severity and avoid complications.

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Section: Discussioncontrasting

confidence: 52%

Costs associated with influenza-related hospitalization in the elderly

Torner

Navas²,

Soldevila

et al. 2016

Human Vaccines & Immunotherapeutics

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“…The median cost of the P&I hospitalizations during the study period was 2625 RMB (equal to 423 USD with a ratio of 1 USD:6.2 RMB); this cost was a little lower than that found in our previous study conducted with children hospitalized with influenza infection (624 USD), but much higher than the result of another study from China of 231 USD per influenza hospitalization among children ≤15 years from 2009 to 2011 . These differences are influenced by local economics, as the income and salary are higher in Suzhou than in other areas of China, and the definition of the diseases varies between the studies.…”

Section: Discussionmentioning

confidence: 57%

Pneumonia and influenza hospitalizations among children under 5 years of age in Suzhou, China, 2005–2011

Zhang

Zhang²,

Chen³

et al. 2016

Influenza Resp Viruses

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BackgroundThe disease burden of influenza among children in China has not been well described.ObjectiveTo estimate the influenza‐associated excess hospitalization rate and compare the hospitalization length and costs between pneumonia and influenza (P&I) and other community‐acquired diseases (CAD) in Suzhou, China.MethodsWe retrospectively collected hospital discharge data on pediatric patients' discharge diagnosis, hospital costs, and length of hospital stay in Suzhou. P&I hospitalization was defined as a primary discharge diagnosis of pneumonia and influenza disease (ICD‐10 codes J09–J18). Other CAD were common community‐acquired diseases among children. Negative binomial regression models were used to estimate the weekly P&I hospitalizations in Suzhou. Excess P&I hospitalizations due to influenza were calculated as the difference in P&I hospitalizations between the epidemic period and the baseline period. Baseline was defined as when the influenza‐positive rates were <5% for two consecutive weeks.ResultsFrom October 2005 to September 2011, we identified a total of 180 091 all‐cause hospitalizations among children <5 years of age in Suzhou City. The rates of P&I and influenza‐associated excess hospitalizations were highest in the 2009–2010 pandemic and 2010–2011 post‐pandemic seasons. Infants <6 months of age had the highest P&I hospitalization rates, the longest hospital stays (7.5–8.0 days), and the highest hospitalization costs for P&I. Compared with other CAD, children admitted for P&I had longer hospital stays and higher hospitalization costs.ConclusionsThe influenza‐associated P&I hospitalization rates and economic burden were high among children. Targeted influenza prevention and control strategies for young children in Suzhou may reduce the influenza‐associated hospitalizations in this age group.

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“…2). The potential for the interventions to be cost-saving was only estimated when we assumed a severe illness treatment cost for each CRI case (US $525, 3255 RMB) [22]. This is an extreme scenario and is unlikely except in a highly pathogenic influenza epidemic/pandemic where a mean case requires substantial healthcare treatment.…”

Section: Sensitivity Analysis Resultsmentioning

confidence: 99%

“…The exclusion of these factors will make our results more conservative. HCWs are known to transmit various types of nosocomial infections to patients [34] and the literature indicates that there are likely to be substantial benefits if the number of patients with CRI is reduced [22]. For example, the benefits of preventing HCW infection transmission through vaccination have been observed in long-term care facilities that found an associated decrease in mortality in their elderly residents [35][36][37].…”

Section: Discussionmentioning

confidence: 99%

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Cost-effectiveness analysis of N95 respirators and medical masks to protect healthcare workers in China from respiratory infections

et al. 2017

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BackgroundThere are substantial differences between the costs of medical masks and N95 respirators. Cost-effectiveness analysis is required to assist decision-makers evaluating alternative healthcare worker (HCW) mask/respirator strategies. This study aims to compare the cost-effectiveness of N95 respirators and medical masks for protecting HCWs in Beijing, China.MethodsWe developed a cost-effectiveness analysis model utilising efficacy and resource use data from two cluster randomised clinical trials assessing various mask/respirator strategies conducted in HCWs in Level 2 and 3 Beijing hospitals for the 2008–09 and 2009–10 influenza seasons. The main outcome measure was the incremental cost-effectiveness ratio (ICER) per clinical respiratory illness (CRI) case prevented. We used a societal perspective which included intervention costs, the healthcare costs of CRI in HCWs and absenteeism costs.ResultsThe incremental cost to prevent a CRI case with continuous use of N95 respirators when compared to medical masks ranged from US $490–$1230 (approx. 3000-7600 RMB). One-way sensitivity analysis indicated that the CRI attack rate and intervention effectiveness had the greatest impact on cost-effectiveness.ConclusionsThe determination of cost-effectiveness for mask/respirator strategies will depend on the willingness to pay to prevent a CRI case in a HCW, which will vary between countries. In the case of a highly pathogenic pandemic, respirator use in HCWs would likely be a cost-effective intervention.

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Direct Medical Cost of Influenza-Related Hospitalizations among Severe Acute Respiratory Infections Cases in Three Provinces in China

Cited by 26 publications

References 11 publications

Costs associated with influenza-related hospitalization in the elderly

Costs associated with influenza-related hospitalization in the elderly

Pneumonia and influenza hospitalizations among children under 5 years of age in Suzhou, China, 2005–2011

Cost-effectiveness analysis of N95 respirators and medical masks to protect healthcare workers in China from respiratory infections

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