Initial and Long-Term Costs of Patients Hospitalized with West Nile Virus Disease

Staples, J. Erin; Shankar, Manjunath; Sejvar, James J.; Meltzer, Martin I.; Fischer, Marc

doi:10.4269/ajtmh.13-0206

Cited by 58 publications

(53 citation statements)

References 18 publications

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“…The appropriate economic value per WNND case depends on the case disposition with respect to the patient's survival (i.e., nonfatal or fatal). For nonfatal outcomes, [28] reported the mean reimbursement for incurred hospital charges for subsets of WNND patients distinguished by their syndromes. Sixty-two patients in this group were determined to have conditions consistent with CDC's clinical criteria for WNND, including diagnoses of meningitis, encephalitis, or acute flaccid paralysis [8].…”

Section: Monetizing Temperature-related Wnnd Casesmentioning

confidence: 99%

“…The weighted mean hospital reimbursement for these 62 patients was $41,391 after adjusting the original study values using a government price index [29] (values in our paper are in undiscounted 2015 U.S. dollars unless stated otherwise). These hospitalization costs do not account for lost productivity during the hospitalization, related follow-up outpatient costs, or pain and suffering associated with the episode [28]. Thus, this represents a conservative estimate of the value of a nonfatal WNND case.…”

Section: Monetizing Temperature-related Wnnd Casesmentioning

confidence: 99%

“…The [28]] study reported 6 of the 62 patients (9.7%) with conditions consistent with WNND died during their initial hospitalization. The mortality rate in this sample contrasts with a 6.5% mortality rate reported in the national summary of 2014 WNND cases, reflecting 87 deaths from among 1347 WNND cases [2].…”

Section: Monetizing Temperature-related Wnnd Casesmentioning

confidence: 99%

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Impacts of Increasing Temperature on the Future Incidence of West Nile Neuroinvasive Disease in the United States

Belová¹,

Mills²,

Hall³

et al. 2017

AJCC

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Multiple studies have identified links between climate and West Nile virus disease since the virus arrived in North America. Here we sought to extend these results by developing a Health Impact Function (HIF) to generate county-level estimates of the expected annual number of West Nile neuroinvasive disease (WNND) cases based on the county's historical WNND incidence, annual average temperature, and population size. To better understand the potential impact of projected temperature change on WNND risk, we used the HIF to project the change in expected annual number of WNND cases attributable to changing temperatures by 2050 and by 2090 using data from five global climate models under two representative concentration pathways (RCP4.5 and RCP8.5). To estimate the costs of anticipated changes, as well as to enable comparisons with other public health impacts, projected WNND cases were allocated to nonfatal and fatal outcomes, then monetized using a cost-of-illness estimate and the U.S. Environmental Protection Agency's value of a statistical life, respectively. We found that projected future temperature and population changes could increase the expected annual number of WNND cases to ≈2000 -2200 cases by 2050 and to ≈2700 -4300 cases by 2090, from a baseline of 970 cases. Holding population constant at future levels while varying temperature from a 1995 baseline, we estimated projected temperature change alone is responsible for ≈590 and ≈960 incremental WNND cases in 2050 and 2090 (respectively) under the RCP4.5 scenario, and ≈820 and ≈2500 cases in 2050 and 2090 (respectively) for the RCP8.5 scenario, with substantial regional variation. The monetized impact of these temperature-attributable incremental cases is estimated at $0.5 billion in 2050 and $1.0 billion in 2090 How to cite this

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Section: Monetizing Temperature-related Wnnd Casesmentioning

confidence: 99%

Section: Monetizing Temperature-related Wnnd Casesmentioning

confidence: 99%

See 1 more Smart Citation

Impacts of Increasing Temperature on the Future Incidence of West Nile Neuroinvasive Disease in the United States

Belová¹,

Mills²,

Hall³

et al. 2017

AJCC

View full text Add to dashboard Cite

show abstract

“…Disease burden and economic costs over the short and long-term are considered to be significant from complications and hospitalizations that can result in death [3–6]. High-quality data on hospitalization and mortality are important for guiding patient care and healthcare decision-making.…”

Section: Introductionmentioning

confidence: 99%

Epidemiologic and clinical parameters of West Nile virus infections in humans: a scoping review

et al. 2017

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BackgroundClinical syndromes associated with West Nile virus (WNV) infection range from fever to neuroinvasive disease. Understanding WNV epidemiology and disease history is important for guiding patient care and healthcare decision-making. The objective of this review was to characterize the existing body of peer-reviewed and surveillance literature on WNV syndromes and summarize epidemiologic and clinical parameters.MethodsWe followed scoping review methodology described by the Joanna Briggs Institute. Terms related to WNV epidemiology, hospitalization, and surveillance were searched in four bibliographic databases (MEDLINE, EMBASE, Scopus, and CINAHL) for literature published from January 1999 to December 2015.ResultsIn total, 2334 non-duplicated titles and abstracts were screened; 92 primary studies were included in the review. Publications included one randomized controlled trial and 91 observational studies. Sample sizes ranged from under 25 patients (n = 19) to over 400 patients (n = 28). Eight studies were from Canada, seven from Israel, and the remaining (n = 77) from the United States. N = 17 studies were classified as outbreak case investigations following epidemics; n = 37 with results of regional/national surveillance and monitoring programs.Mean patient ages were > 40 years old; three studies (3%) focused on the pediatric population. Patients with encephalitis fared worse than patients with meningitis and fever, considering hospitalization, length of stay, discharge, recovery, and case-fatality. Several studies examined risk factors; however, age was the only risk factor for neuroinvasive disease/death consistently identified. Overall, patients with acute flaccid paralysis or encephalitis fared worse than patients with meningitis and West Nile fever in terms of hospitalization and mortality. Among the included studies, proportion hospitalized, length of stay, proportion discharged home and case-fatality ranged considerably.ConclusionOur review highlights the heterogeneity among reporting clinical WNV syndromes and epidemiologic parameters of WNV-related illness. Presently, there is potential for further synthesis of the risk factors of WNV-illness and mortality; undertaking further analysis through a systematic review and meta-analysis may benefit our understanding of risk factors for emerging mosquito-borne diseases. Future research on the burden of WNV can build on existing evidence summarized in this review, not only to support our understanding of endemic WNV, but also to strengthen research on emerging arboviruses with similar clinical manifestations.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-017-2637-9) contains supplementary material, which is available to authorized users.

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“…As a previous study estimated the costs for meningitis and encephalitis to be quite similar [35], our work distinguished between two main syndromes: meningoencephalitis and AFP.…”

Section: Methodsmentioning

confidence: 88%

Estimating the economic impact of a possible equine and human epidemic of West Nile virus infection in Belgium

et al. 2016

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This study aimed at estimating, in a prospective scenario, the potential economic impact of a possible epidemic of WNV infection in Belgium, based on 2012 values for the equine and human health sectors, in order to increase preparedness and help decision-makers. Modelling of risk areas, based on the habitat suitable for Culex pipiens, the main vector of the virus, allowed us to determine equine and human populations at risk. Characteristics of the different clinical forms of the disease based on past epidemics in Europe allowed morbidity among horses and humans to be estimated. The main costs for the equine sector were vaccination and replacement value of dead or euthanised horses. The choice of the vaccination strategy would have important consequences in terms of cost. Vaccination of the country’s whole population of horses, based on a worst-case scenario, would cost more than EUR 30 million; for areas at risk, the cost would be around EUR 16–17 million. Regarding the impact on human health, short-term costs and socio-economic losses were estimated for patients who developed the neuroinvasive form of the disease, as no vaccine is available yet for humans. Hospital charges of around EUR 3,600 for a case of West Nile neuroinvasive disease and EUR 4,500 for a case of acute flaccid paralysis would be the major financial consequence of an epidemic of West Nile virus infection in humans in Belgium.

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Initial and Long-Term Costs of Patients Hospitalized with West Nile Virus Disease

Cited by 58 publications

References 18 publications

Impacts of Increasing Temperature on the Future Incidence of West Nile Neuroinvasive Disease in the United States

Impacts of Increasing Temperature on the Future Incidence of West Nile Neuroinvasive Disease in the United States

Epidemiologic and clinical parameters of West Nile virus infections in humans: a scoping review

Estimating the economic impact of a possible equine and human epidemic of West Nile virus infection in Belgium

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