1. Healthcare utilization and cost of pneumococcal disease in the United States
- Author
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Huang, Susan S, Johnson, Kristen M, Ray, G Thomas, Wroe, Peter, Lieu, Tracy A, Moore, Matthew R, Zell, Elizabeth R, Linder, Jeffrey A, Grijalva, Carlos G, Metlay, Joshua P, and Finkelstein, Jonathan A
- Subjects
Health Services and Systems ,Biomedical and Clinical Sciences ,Clinical Sciences ,Health Sciences ,Vaccine Related ,Pneumonia & Influenza ,Lung ,Clinical Research ,Health Services ,Pneumonia ,Infectious Diseases ,Immunization ,2.4 Surveillance and distribution ,Infection ,Good Health and Well Being ,Adolescent ,Adult ,Aged ,Child ,Child ,Preschool ,Delivery of Health Care ,Health Care Costs ,Humans ,Infant ,Inpatients ,Middle Aged ,Models ,Economic ,Otitis Media ,Outpatients ,Pneumococcal Infections ,Sepsis ,Sinusitis ,United States ,Young Adult ,Pneumococcus ,Streptococcus pneumoniae ,Economic analysis ,Disease burden ,cephalosporin derivative ,penicillin derivative ,Pneumococcus vaccine ,adolescent ,adult ,age distribution ,aged ,article ,child ,death ,emergency ward ,female ,health care cost ,health care utilization ,health survey ,hospital cost ,hospital discharge ,hospitalization ,human ,infant ,major clinical study ,male ,medical care ,otitis media ,outpatient department ,pneumococcal infection ,pneumonia ,preschool child ,priority journal ,productivity ,school child ,sinusitis ,vaccination ,work capacity ,Biological Sciences ,Agricultural and Veterinary Sciences ,Medical and Health Sciences ,Virology ,Biomedical and clinical sciences ,Health sciences - Abstract
BackgroundStreptococcus pneumoniae continues to cause a variety of common clinical syndromes, despite vaccination programs for both adults and children. The total U.S. burden of pneumococcal disease is unknown.MethodsWe constructed a decision tree-based model to estimate U.S. healthcare utilization and costs of pneumococcal disease in 2004. Data were obtained from the 2004-2005 National (Hospital) Ambulatory Medical Care Surveys (outpatient visits, antibiotics) and the National Hospital Discharge Survey (hospitalization rates), and CDC surveillance data. Other assumptions regarding the incidence of each syndrome due to pneumococcus, expected health outcomes, and healthcare utilization were derived from literature and expert opinion. Healthcare and time costs used 2007 dollars.ResultsWe estimate that, in 2004, pneumococcal disease caused 4.0 million illness episodes, 22,000 deaths, 445,000 hospitalizations, 774,000 emergency department visits, 5.0 million outpatient visits, and 4.1 million outpatient antibiotic prescriptions. Direct medical costs totaled $3.5 billion. Pneumonia (866,000 cases) accounted for 22% of all cases and 72% of pneumococcal costs. In contrast, acute otitis media and sinusitis (1.5 million cases each) comprised 75% of cases but only 16% of direct medical costs. Patients ≥ 65 years old, accounted for most serious cases and the majority of direct medical costs ($1.8 billion in healthcare costs annually). In this age group, pneumonia caused 242,000 hospitalizations, 1.4 million hospital days, 194,000 emergency department visits, 374,000 outpatient visits, and 16,000 deaths. However, if work loss and productivity are considered, the cost of pneumococcal disease among younger working adults (18-
- Published
- 2011