Direct Medical Costs of 3 Reportable Travel-Related Infections in Ontario, Canada, 2012–2014

Abstract

Immigrants traveling to their birth countries to visit friends or relatives are disproportionately affected by travel-related infections, in part because most preventive travel health services are not publicly funded. To help identify cost-effective policies to reduce this disparity, we measured the medical costs (in 2015 Canadian dollars) of 3 reportable travel-related infectious diseases (hepatitis A, malaria, and enteric fever) that accrued during a 3-year period (2012–2014) in an ethnoculturally diverse region of Canada (Peel, Ontario) by linking reportable disease surveillance and health administrative data. In total, 318 case-patients were included, each matched with 2 controls. Most spending accrued in inpatient settings. Direct healthcare spending totaled $2,058,196; the mean attributable cost per case was $6,098 (95% CI $5,328–$6,868) but varied by disease (range $4,558–$7,852). Costs were greatest for enteric fever. Policies that address financial barriers to preventive health services for high-risk groups should be evaluated.

Risk of malaria associated with travel to malaria-endemic areas to visit friends and relatives: a population-based case–control study

“…Instead, this population is often treated by health policy decisionmakers as having the same needs and ability to pay as tourists. 28 By creating financial and structural barriers to pretravel clinical prevention for groups at high risk, an unnecessary burden may be placed on the health care sys tem in that expensive posttravel medical interventions may be needed for preventable conditions. Previous studies suggest that financial support is a more effective strategy than educa tion and awareness in dealing with the health risks of travelling to visit friends and relatives.…”

Geographic clustering of travel-acquired infections in Ontario, Canada, 2008–2020

“…Similar to the United States, Ontario's universal health insurance program does not cover PTA, travel-related immunizations nor chemoprophylaxis [40]. Given this barrier and the potentially high healthcare costs linked to the management of TAIs, our findings highlight the need for cost effectiveness analyses evaluating the financial benefits of travel clinics on TAI prevention as well as pilot programs for PTA cost coverage in high-incidence communities [15]. The last dimension of access to health services, acceptability, may be the most complex barrier to address as it encompasses numerous dimensions of risk perception [41].…”

“…Among sub-national jurisdictions in North America, only New York State has a higher reported rate of malaria cases than Ontario [13,14]. In addition to the morbidity caused by these TAIs, attributable medical costs in Ontario have been calculated to be CAD$4,558 per case of malaria and CAD$7,852 per case of enteric fever [15].…”