Both type of disease and age of patient had statistically significant effects on treatment costs. The results showed that treatment costs for bacterial diseases in children were considerable and might differ by as much as seven times among invasive pneumococcal diseases.
Changes in costs were sensitive to both age of patient and case-category. These cost-of-illness data will be an important component in the overall evidence base to guide the development of vaccine policy in Viet Nam. Globally, nearly two million children die each year due to acute respiratory tract infections ARIs 1.
Besides, an estimated million episodes of childhood pneumonia occur, of which million require hospitalization 2. The incidence of pneumonia among children aged less than five years is estimated to be 0.
A large proportion of these deaths could be averted through routine immunization using available pneumococcal conjugate vaccines 4 , 5. However, a substantial barrier to the use of pneumococcal conjugate vaccine is the non-availability of adequate information on costs associated with treatment of clinical conditions consistent with invasive pneumococcal diseases in children.
In addition, an increasing number of countries are now requesting or requiring cost-of-illness data on vaccine-preventable diseases before making long-term commitments for the introduction of new vaccines.
At present, only a limited number of studies reported costs associated with syndromes of invasive bacterial infections in children from developing countries 6 — 8.
To address this gap in information, we determined costs for the treatment of invasive bacterial infection syndromes in children in Nha Trang, Viet Nam. We conducted an incidence-based cost-of-illness analysis from the healthcare system perspective, a technique used for measuring the economic burden of patients from the onset to the end of illness 9 , During , a prospective surveillance for clinical syndromes associated with invasive pneumococcal diseases was conducted at the KHGH; its results were published elsewhere Before the enrollment of study patients, all clinicians and medical staff of the Department of Pediatrics and Infectious Diseases of KHGH were provided with standardized procedures and screening criteria for identifying children with pneumonia, meningitis, sepsis, and other syndromes consistent with invasive bacterial diseases.
All specimens were tested using bacterial culture methods, and selected specimens underwent further testing by antigen detection and polymerase chain reaction. For our analysis, cost-of-illness was defined as the sum of direct medical, direct non-medical, and indirect costs 9. Direct medical cost was defined as costs directly associated with provision of healthcare, including costs for detection, treatment, continuing care, rehabilitation, and terminal care.
For this study, we focused our analysis on direct medical or treatment costs employing the micro-costing approach that estimates costs of treatment by summing all medical services received by an individual patient Vietnamese children, aged less than six years, are now covered under a national health insurance supported by the Vietnamese government. In Viet Nam, public hospitals receive government funding in the form of lump sum budget and insurance system reimbursements for delivery of medical services to patients.
For the health insurance, hospital costs are reimbursed by the Ministry of Health using a fee-for-service system. To compute costs of each medical service, we used the ratio of costs to charges RCCs method 15 , In this method, the RCC takes into account all costs incurred by the hospital and the hospital's total revenue i.
Then, the total annual hospital costs were divided by total annual revenue or total charges to derive the overall RCC. We then multiplied charges for each service by the RCC to obtain costs of a service item for each patient. We summed the costs of all medical services and drugs of each patient to obtain total direct medical costs or treatment costs for each patient. Total hospital cost included labour cost of all hospital staff, material cost e. Capital costs associated with the use of depreciable assets, i.
The capital cost was calculated based on the straight-line equivalent annual economics-based approach The cost is equally allocated to period of useful life.
Based on the Ministry of Finance guidelines, we assumed that the useful life of vehicles, equipment, and buildings was 5, 10 and 25 years respectively We covered all items in use, although they were over official working years since they still had opportunity cost Demographic information was described by frequency and proportion.
We calculated means with standard deviations SDs for continuous variables and used multiple regression analysis to explore the factors associated with variations in treatment costs. Covariates considered in this modelling included age months , duration of stay days , and diagnosis. In addition, since prices of drugs may vary substantially among hospitals, we performed a sensitivity analysis to explore the effect of variation in prices of antibiotics across a range of prices of antibiotics available from the KHGH databases.
In total, children were enrolled in the study. Their average age was The majority Of the children, Of the children with a specific diagnosis, All the enrolled patients were treated in the inpatient facilities of the KHGH, and the average duration of hospitalization was 6. To convert the payment to economic cost, the cost-to-charge ratio method was applied. Article Google Scholar. Risk of pneumococcal disease in children with chronic medical conditions in the era of pneumococcal conjugate vaccine.
Clin Infect Dis. Rates of pneumococcal disease in adults with chronic medical conditions. Open Forum Infect Dis. Clinical and economic burden of community-acquired pneumonia in the medicare free-for-service population. J Am Geriatr Soc. Rates and costs of invasive pneumococcal disease and pneumonia in persons with underlying medical conditions. Comorbidities as a driver of the excess costs of community-acquired pneumonia in US commercially-insured working age adults.
Appl Health Econ Health Policy. Work-related and health care cost burden of community-acquired pneumonia in an employed population. J Occup Environ Med. Treatment costs of community-acquired pneumonia in an employed population. Risk of exacerbation following pneumonia in adults with heart failure or chronic obstructive pulmonary disease.
Long-term cost consequences of community-acquired pneumonia in adults. Am J Pharm Benefits. Google Scholar. Incidence and cost of pneumonia in medicare beneficiaries. Arch Intern Med. Sub-part D: additional protections for children involved as subjects in research. Download references. Policy Analysis Inc. You can also search for this author in PubMed Google Scholar. Correspondence to Derek Weycker. Reiko Sato is an employee of, and owns stock in, Pfizer Inc.
The data are proprietary, provided by a third-party vendor, and the authors do not have permission to disseminate the data without approval of the vendor.
Authorship was designated based on the guidelines promulgated by the International Committee of Medical Journal Editors All persons who meet the criteria for authorship are listed as authors on the title page.
The study sponsor reviewed the study research plan and the study manuscript; data management, processing, and analyses were conducted by PAI, and all final analytic decisions were made by the study investigators. All authors read and approved the final version of the manuscript. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material.
If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. Reprints and Permissions. Weycker, D. PharmacoEconomics Open 5, — Download citation. Accepted : 30 October Cases can be mild or severe and often the vaccinations for each keep these illnesses at bay or lessen their intensity,.
Community-acquired or contagious pneumonia, which can be caused by bacteria, virus or fungi, is statistically high. Those at higher risk include the elderly and young children. About 81 percent of that price tag has been for the care and treatment of pneumonia patients.
During the flu season there were about , hospitalizations for influenza cases alone, again according to the CDC. Back in 1. Separate studies analyzing the hospitalization rate of individuals with pneumonia and influenza between and reported pneumonia hospitalization rates by Klebsiella species, Pseudomonas species, S. Pneumonia caused by H. Direct medical costs and utilization of health care services to treat pneumonia in the United States: an analysis of the medical expenditure panel survey.
Clin Ther. Racial and regional differences in rates of invasive pneumococcal disease. Cost-effectiveness of valent pneumococcal conjugate vaccine PCV13 in older Australians. Cost-effectiveness of pneumococcal vaccines for adults in the United States. Adv Ther. Cost-effectiveness of pneumococcal vaccination of older people: a study in 5 western European countries.
Clin Infect Dis. Cost-effectiveness of adult vaccination strategies using pneumococcal conjugate vaccine compared with pneumococcal polysaccharide vaccine. Download references. This study and medical writing for this manuscript were funded by Sanofi Pasteur. Sanofi Pasteur had no role in the design of the study, the writing of the manuscript, or in the collection, analysis, or interpretation of the data.
Otherwise, all data and calculations are available in the manuscript and the accompanying supplemental tables. You can also search for this author in PubMed Google Scholar.
All authors were involved in interpreting the data; reviewed and edited the article; approved the final version of the manuscript; and agreed to be accountable for its contents.
MHK and AK conceptualized the study. ST and CA analyzed the data. MHK and ST participated in developing the first draft of the article. Correspondence to Moe H. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Table S1. DOCX 13 kb. Table S3. Frequency of index pneumonia visits per person-years by age group and year DOCX 13 kb. Reprints and Permissions. Tong, S. Trends in healthcare utilization and costs associated with pneumonia in the United States during — Download citation.
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Search all BMC articles Search. Download PDF. Abstract Background Pneumonia is the leading cause of morbidity and mortality worldwide. Results The overall annual healthcare utilization rate for pneumonia was Conclusions The burden of pneumonia on the US healthcare system remains substantial.
Methods Study design This was a retrospective analysis of pneumonia-related healthcare utilization in the US. Data source and extraction The MarketScan database contains information on US individuals insured commercially i.
Results Pneumonia cases Between January 1, and December 31, , an average of 41,, PY were included in the database each year. Demographics of pneumonia cases Slightly less than half of pneumonia patients were male Table 1 Demographic characteristics of pneumonia patients in the MarketScan database between and Full size table.
Table 2 Frequency of index pneumonia cases per person-years by setting and age group between and Full size table. Overall rate of index pneumonia cases between and Full size image.
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