Treatment costs of pneumonia, meningitis, sepsis, and other diseases among hospitalized children in Viet Nam

Dang Duc Anh, Arthorn Riewpaiboon, Le Huu Tho, Soon Ae Kim, Batmunkh Nyambat, Paul Kilgore, Dang Duc Anh, Arthorn Riewpaiboon, Le Huu Tho, Soon Ae Kim, Batmunkh Nyambat, Paul Kilgore

Abstract

The aim of this study was to estimate the costs of treatment of children who present with the signs and symptoms of invasive bacterial diseases in Khanh Hoa province, Viet Nam. The study was an incidence-based cost-of-illness analysis from the health system perspective. The hospital costs included labour, materials and capital costs, both direct and indirect. Costs were determined for 980 children, with an average age of 12.67 months (standard deviation +/- 11.38), who were enrolled in a prospective surveillance at the Khanh Hoa General Hospital during 2005-2006. Of them, 57% were male. By disease-category, 80% were suspected of having pneumonia, 8% meningitis, 3% very severe disease consistent with pneumococcal sepsis, and 9% other diseases. Treatment costs for suspected pneumonia, meningitis, very severe disease, and other diseases were US$ 31, US$ 57, US$ 73, and US$ 24 respectively. Costs ranged from US$ 24 to US$ 164 across different case-categories. 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.

Figures

Fig.
Fig.
Age-specific treatment cost estimated by modelling

References

    1. Williams BG, Gouws E, Boschi-Pinto C, Bryce J, Dye C. Estimates of world-wide distribution of child deaths from acute respiratory infections. Lancet Infect Dis. 2002;2:25–32.
    1. Rudan I, Tomaskovic L, Boschi-Pinto C, Campbell H, WHO Child Health Epidemiology Reference Group Global estimate of the incidence of clinical pneumonia among children under five years of age. Bull World Health Organ. 2004;82:895–903.
    1. United Nations Children's Fund. Pneumonia: the forgotten killer of children. New York, NY: United Nations Children's Fund; 2006. p. 40.
    1. Levine OS, Cutts FT. Pneumococcal vaccination and public health. Lancet. 2007;369:1144–5.
    1. Madhi SA, Levine OS, Hajjeh R, Mansoor OD, Cherian T. Vaccines to prevent pneumonia and improve child survival. Bull World Health Organ. 2008;86:365–72.
    1. Ayieko P, Akumu AO, Griffiths UK, English M. The economic burden of inpatient paediatric care in Kenya: household and provider costs for treatment of pneumonia, malaria and meningitis. Cost Eff Resour Alloc. 2009;7:3.
    1. Chola L, Robberstad B. Estimating average inpatient and outpatient costs and childhood pneumonia and diarrhoea treatment costs in an urban health centre in Zambia. Cost Eff Resour Alloc. 2009;7:16.
    1. Madsen HO, Hanehoj M, Das AR, Moses PD, Rose W, Puliyel M, et al. Costing of severe pneumonia in hospitalized infants and children aged 2–36 months, at a secondary and tertiary level hospital of a not-for-profit organization. Trop Med Int Health. 2009;14:1315–22.
    1. Kobelt G. Health economics: an introduction to economic evaluation, 2nd ed. London: Office of Health Economics; 2002. p. 131.
    1. Joint United Nations Programme on HIV/AIDS. Costing guidelines for HIV prevention strategies. Geneva: Joint United Nations Programme on HIV/AIDS; 2000. p. 136.
    1. Anh DD, Kilgore PE, Slack MP, Nyambat B, Tho le H, Yoshida LM, et al. Surveillance of pneumococcal-associated disease among hospitalized children in Khanh Hoa province, Vietnam. Clin Infect Dis. 2009;48(Suppl 2):S57–64.
    1. World Health Organization. Pneumonia Vaccine Trial Investigators Group. Standardization of interpretation of chest radiographs for the diagnosis of pneumonia in children. Geneva: Department of Vaccines and Biologicals, World Health Organization; 2001. p. 32. (WHO/V&B/01.35).
    1. Knoll MD, Moïsi JC, Muhib FB, Wonodi CB, Lee EH, Grant L, et al. Standardizing surveillance of pneumococcal disease. Clin Infect Dis. 2009;48(Suppl 2):S37–48.
    1. Brouwer W, Rutten F, Koopmanschap M. Costing in economic evaluations. In: Drummond M, McGuire A, editors. Economic evaluation in health care—merging theory with practice. New York, NY: Oxford University Press; 2001. pp. 68–93.
    1. Finkler SA. The distinction between cost and charges. Ann Intern Med. 1982;96:102–9.
    1. Suver JD, Cooper JC. Principles and methods of managerial cost-accounting systems. Am J Hosp Pharm. 1988;45:146–52.
    1. Drummond MF, Sculpher MJ, Torrance GW, O'Brien BJ, Stoddart GL. Methods for the economic evaluation of health care programmes, 3rd ed. Oxford: Oxford University Press; 2005. p. 396.
    1. World Health Organization. Making choices in health: WHO guide to cost-effectiveness analysis. Geneva: World Health Organization; 2003. p. 318.
    1. Flessa S, Dung NT. Costing of services of Vietnamese hospitals: identifying costs in one central, two provincial and two district hospitals using a standard methodology. Int J Health Plann Manage. 2004;19:63–77.
    1. Vietcombank. Exchange rate. ( , accessed on 21 January 2008).
    1. Lagos R, Muñoz A, San Martin O, Maldonado A, Hormazabal JC, Blackwelder WC, et al. Age- and serotype-specific pediatric invasive pneumococcal disease: insights from systematic surveillance in Santiago, Chile, 1994–2007. J Infect Dis. 2008;198:1809–17.
    1. Lagos R, Muñoz A, Valenzuela MT, Heitmann I, Levine MM. Population-based surveillance for hospitalized and ambulatory pediatric invasive pneumococcal disease in Santiago, Chile. Pediatr Infect Dis J. 2002;21:1115–23.
    1. Anh DD, Huong Ple T, Watanabe K, Nguyet NT, Anh NT, Thi NT, et al. Increased rates of intense nasopharyngeal bacterial colonization of Vietnamese children with radiological pneumonia. Tohoku J Exp Med. 2007;213:167–72.
    1. Hussain H, Waters H, Khan AJ, Omer SB, Halsey NA. Economic analysis of childhood pneumonia in northern Pakistan. Health Policy Plan. 2008;23:438–42.
    1. Hussain H, Waters H, Omer SB, Khan A, Baig IY, Mistry R, et al. The cost of treatment for child pneumonias and meningitis in the northern areas of Pakistan. Int J Health Plann Manage. 2006;21:229–38.
    1. World Bank Group. GNP per capita. ( , accessed on 11 March 2010).
    1. Riewpaiboon A, Malaroje S, Kongsawatt S. Effect of costing methods on unit cost of hospital medical services. Trop Med Int Health. 2007;12:554–63.
    1. Riewpaiboon A, Jaroenkitpan N, Wipaswacharayotin Y. Cost structure of hospital-based pharmaceutical services: a consideration of reimbursement. Mahidol Univ J Pharm Sci. 2005;32:47–54.
    1. Riewpaiboon A, Piyauthakit P, Chaikledkaew U. Economic burden of road traffic injuries: a micro-costing approach. Southeast Asian J Trop Med Public Health. 2008;39:1139–49.
    1. Anh DD, Yen NTB, Riewpaiboon A. Institutional cost of shigellosis at Khanh Hoa Hospital and lower health facilities in Vietnam. Hanoi: National Institute of Hygiene and Epidemiology; 2008. p. 50.
    1. Watkins C, Harvey I, Carthy P, Moore L, Robinson E, Brawn R. Attitudes and behaviour of general practitioners and their prescribing costs: a national cross sectional survey. Qual Saf Health Care. 2003;12:29–34.
    1. Drummond M, McGuire A. Economic evaluation in health care: merging theory with practice. Oxford: Oxford University Press; 2001. p. 296.

Source: PubMed

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