Rates and costs of invasive pneumococcal disease and pneumonia in persons with underlying medical conditions
| Autor: | Stephen I. Pelton, Derek Weycker, John Edelsberg, David R. Strutton, Raymond Farkouh, Kimberly M. Shea |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male medicine.medical_specialty 030231 tropical medicine Comorbidity Patient Care Planning Pneumococcal Infections Diabetes Complications Pneumococcal Vaccines 03 medical and health sciences 0302 clinical medicine Risk Factors Economic cost Health care medicine Humans 030212 general & internal medicine Intensive care medicine Child Asthma Aged Retrospective Studies business.industry Public health Health Policy Cost and cost analysis Infant Newborn Infant Retrospective cohort study Pneumonia Health Care Costs Middle Aged Pneumonia Pneumococcal medicine.disease United States Pneumococcal infections Streptococcus pneumoniae Child Preschool Female business Research Article |
| Zdroj: | BMC Health Services Research |
| ISSN: | 1472-6963 |
| Popis: | Background The presence of certain underlying medical conditions is known to increase the risk of pneumococcal disease in persons of all ages and across a wide spectrum of conditions, as demonstrated in two recent evaluations. Corresponding estimates of attributable economic costs have not been well characterized. We thus undertook a retrospective evaluation to estimate rates and costs of pneumococcal disease among children and adults with and without underlying medical conditions in the United States. Methods Data were obtained from three independent healthcare claims repositories. The study population included all persons enrolled in participating health plans during 2007–2010, and was stratified into subgroups based on age and risk profile: healthy; at-risk, due to selected comorbid conditions; and high-risk, due to selected immunocompromising conditions. At-risk and high-risk conditions, as well as episodes of invasive pneumococcal disease (IPD) and all-cause pneumonia (PNE), were identified via diagnosis, procedure, and drug codes. Rates and healthcare costs of IPD and PNE (2010US$) among at-risk and high-risk persons were compared with those from age-stratified healthy counterparts using incidence rate ratios (IRR) and cost ratios. Results Rates of IPD and PNE were consistently higher among at-risk persons (IRR = 4.1 [95 % CI 3.9–4.3] and 4.5 [4.49–4.53]) and high-risk persons (IRR = 10.3 [9.7–11.0] and 8.2 [8.2–8.3]) of all ages versus their healthy counterparts. Rates were notably high for at-risk persons with ≥2 conditions (IRR = 9.0 [8.4–9.7] and 10.3 [10.3–10.4]), as well as those with asthma (IRR = 3.4 [3.0–3.8] and 4.5 [4.47–4.53]) or diabetes (IRR = 4.3 [4.0–4.6] and 4.7 [4.6–4.7]). Healthcare costs totaled $21.7 million per 100,000 at-risk person-years and $58.5 million per 100,000 high-risk person-years, which were 8.7 [8.5–8.8] and 23.4 [22.9–23.8] times higher than corresponding costs for healthy persons. Conclusions Rates and costs of IPD and PNE are substantially higher among persons with certain chronic and immunocompromising conditions versus those without any such conditions. Rates and costs for persons with asthma and diabetes were especially increased, and rates and costs for individuals with ≥2 at-risk conditions approached those among persons with high-risk conditions. Electronic supplementary material The online version of this article (doi:10.1186/s12913-016-1432-4) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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