Indirect, out-of-pocket and medical costs from influenza-related illness in young children

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• 作者：Ismael R. Ortega-Sanchez^a ; ¹ ; ^{IOrtegaSanchez@cdc.gov} ; Noelle-Angelique M. Molinari^a ; ¹ ; Gerry Fairbrother^b ; ¹ ; Peter G. Szilagyi^c ; ¹ ; Kathryn M. Edwards^d ; ¹ ; Marie R. Griffin^d ; ¹ ; Amy Cassedy^b ; ¹ ; Katherine A. Poehling^d ; ¹ ; Carolyn Bridges^a ; ¹ ; Mary Allen Staat^b ; ¹
• 关键词：OOP ; out-of-pocket costs ; ED ; emergency department ; NVSN ; New Vaccine Surveillance Network ; IQR ; inter-quartile range
• 刊名：Vaccine
• 出版年：2012
• 期刊代码：89_0264410x
• 类别：imm
• 出版时间：13 June, 2012
• 卷：30
• 期：28
• 页码：4175-4181
• 文件大小：289 K

摘要

Background

Studies have documented direct medical costs of influenza-related illness in young children, however little is known about the out-of-pocket and indirect costs (e.g., missed work time) incurred by caregivers of children with medically attended influenza.

Objective

To determine the indirect, out-of-pocket (OOP), and direct medical costs of laboratory-confirmed medically attended influenza illness among young children.

Methods

Using a population-based surveillance network, we evaluated a representative group of children aged <5 years with laboratory-confirmed, medically attended influenza during the 2003-2004 season. Children hospitalized or seen in emergency department (ED) or outpatient settings in surveillance counties with laboratory-confirmed influenza were identified and data were collected from medical records, accounting databases, and follow-up interviews with caregivers. Outcome measures included work time missed, OOP expenses (e.g., over-the-counter medicines, travel expenses), and direct medical costs. Costs were estimated (in 2009 US Dollars) and comparisons were made among children with and without high risk conditions for influenza-related complications.

Results

Data were obtained from 67 inpatients, 121 ED patients and 92 outpatients with laboratory-confirmed influenza. Caregivers of hospitalized children missed an average of 73 work hours (estimated cost $1456); caregivers of children seen in the ED and outpatient clinics missed 19 ($383) and 11 work hours ($222), respectively. Average OOP expenses were $178, $125 and $52 for inpatients, ED-patients and outpatients, respectively. OOP and indirect costs were similar between those with and without high risk conditions (p > 0.10). Medical costs totaled $3990 for inpatients and $730 for ED-patients.

Conclusions

Out-of-pocket and indirect costs of laboratory-confirmed and medically attended influenza in young children are substantial and support the benefits of vaccination.