Costs associated with acute respiratory illness and select virus infections in hospitalized children, El Salvador and Panama, 2012-2013
Jorge H Jara, Eduardo Azziz-Baumgartner, Tirza De Leon, Kathia Luciani, Yarisa Sujey Brizuela, Dora Estripeaut, Juan Miguel Castillo, Alfredo Barahona, Mary Corro, Rafael Cazares, Ofelina Vergara, Rafael Rauda, Rosalba González, Danilo Franco, Marc-Alain Widdowson, Wilfrido Clará, Juan P Alvis-Estrada, Christian Travis Murray, Ismael R Ortega-Sanchez, Fatimah S Dawood, Jorge H Jara, Eduardo Azziz-Baumgartner, Tirza De Leon, Kathia Luciani, Yarisa Sujey Brizuela, Dora Estripeaut, Juan Miguel Castillo, Alfredo Barahona, Mary Corro, Rafael Cazares, Ofelina Vergara, Rafael Rauda, Rosalba González, Danilo Franco, Marc-Alain Widdowson, Wilfrido Clará, Juan P Alvis-Estrada, Christian Travis Murray, Ismael R Ortega-Sanchez, Fatimah S Dawood
Abstract
Background and objectives: Although acute respiratory illness (ARI) is a leading cause of hospitalization among young children, few data are available about cost of hospitalization in middle-income countries. We estimated direct and indirect costs associated with severe ARI resulting in hospitalization among children aged <10 years in El Salvador and Panama through the societal perspective.
Methods: During 2012 and 2013, we surveyed caregivers of children hospitalized with ARI about their direct medical (i.e., outpatient consultation, medications, hospital fees), non-medical (transportation, childcare), and indirect costs (lost wages) at discharge and 7 days after discharge. We multiplied subsidized hospital bed costs derived from administrative data by hospitalization days to estimate provider costs.
Results: Overall, 638 children were enrolled with a median age of 12 months (IQR 6-23). Their median length of hospitalization was 4 days (IQR 3-6). In El Salvador, caregivers incurred a median of US$38 (IQR 22-72) in direct and indirect costs per illness episode, while the median government-paid hospitalization cost was US$118 (IQR 59-384) generating an overall societal cost of US$219 (IQR 101-416) per severe ARI episode. In Panama, caregivers incurred a median of US$75 (IQR 39-135) in direct and indirect costs, and the health-care system paid US$280 (IQR 150-420) per hospitalization producing an overall societal cost of US$393 (IQR 258-552).
Conclusions: The cost of severe ARI to caregivers and the health care system was substantive. Our estimates will inform models to estimate national costs of severe ARI and cost-benefit of prevention and treatment strategies.
Trial registration: ClinicalTrials.gov NCT01690637.
Keywords: Acute respiratory illness; Children; El Salvador; Healthcare expenditures; Hospitalized; Panama; Respiratory syncytial virus.
Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.
Source: PubMed