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Socioeconomic costs of children <5 years hospitalised with acute respiratory infections in Kuala Lumpur, Malaysia

•Median societal cost per admitted acute respiratory infection was USD 803 in 2014.•This cost was 1.8 times the Malaysian health expenditure per capita.•Median out-of-pocket cost was 16% of reported monthly household income.•Children with younger age, comorbidity, and prematurity had higher costs. A... Full description

Journal Title: Vaccine 2021-05-21, Vol.39 (22), p.2983-2988
Main Author: Sam, I-Ching
Other Authors: Ahmad Jaafar, Nabeela , Wong, Li Ping , Nathan, Anna Marie , de Bruyne, Jessie Anne , Chan, Yoke Fun
Format: Electronic Article Electronic Article
Language: English
Subjects:
GNI
Publisher: Netherlands: Elsevier Ltd
ID: ISSN: 0264-410X
Link: https://www.ncbi.nlm.nih.gov/pubmed/33931252
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title: Socioeconomic costs of children <5 years hospitalised with acute respiratory infections in Kuala Lumpur, Malaysia
format: Article
creator:
  • Sam, I-Ching
  • Ahmad Jaafar, Nabeela
  • Wong, Li Ping
  • Nathan, Anna Marie
  • de Bruyne, Jessie Anne
  • Chan, Yoke Fun
subjects:
  • Ambulatory care
  • Caregivers
  • Children
  • Consumer Price Index
  • Cost estimates
  • cost of illness
  • Costs
  • Drug prices
  • Economic impact
  • Ethnicity
  • Expenditures
  • Family income
  • Generalized linear models
  • GNI
  • Gross National Income
  • Health aspects
  • health expenditure
  • Health services
  • Hospitalization
  • Households
  • Immunofluorescence
  • Infections
  • Influenza
  • Influenza vaccines
  • Interviews
  • Laboratories
  • Lung diseases
  • Malaysia
  • Medical care, Cost of
  • Medical records
  • Morbidity
  • Mortality
  • Parameter estimation
  • Pneumonia
  • respiratory infections
  • Respiratory syncytial virus
  • Social aspects
  • Streptococcus infections
  • Subsidies
  • Subsidies (financial)
  • Teaching hospitals
  • Vaccines
  • Viruses
ispartof: Vaccine, 2021-05-21, Vol.39 (22), p.2983-2988
description: •Median societal cost per admitted acute respiratory infection was USD 803 in 2014.•This cost was 1.8 times the Malaysian health expenditure per capita.•Median out-of-pocket cost was 16% of reported monthly household income.•Children with younger age, comorbidity, and prematurity had higher costs. Acute respiratory infections (ARI) are a major cause of morbidity and mortality in Malaysian children 
language: eng
source:
identifier: ISSN: 0264-410X
fulltext: no_fulltext
issn:
  • 0264-410X
  • 1873-2518
url: Link


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titleSocioeconomic costs of children <5 years hospitalised with acute respiratory infections in Kuala Lumpur, Malaysia
creatorSam, I-Ching ; Ahmad Jaafar, Nabeela ; Wong, Li Ping ; Nathan, Anna Marie ; de Bruyne, Jessie Anne ; Chan, Yoke Fun
creatorcontribSam, I-Ching ; Ahmad Jaafar, Nabeela ; Wong, Li Ping ; Nathan, Anna Marie ; de Bruyne, Jessie Anne ; Chan, Yoke Fun
description•Median societal cost per admitted acute respiratory infection was USD 803 in 2014.•This cost was 1.8 times the Malaysian health expenditure per capita.•Median out-of-pocket cost was 16% of reported monthly household income.•Children with younger age, comorbidity, and prematurity had higher costs. Acute respiratory infections (ARI) are a major cause of morbidity and mortality in Malaysian children < 5 years. Knowledge of associated economic costs is important for policymakers to determine cost-effectiveness of interventions, such as pneumococcal or influenza vaccines, which are underused in Malaysia. Children < 5 years admitted with ARI to a teaching hospital in Kuala Lumpur were prospectively recruited between July 2013 and July 2015. Medical (with and without government subsidies), non-medical and indirect costs from pre-admission, admission and post-discharge were obtained by interviews with carers and from medical records. Respiratory viruses were diagnosed by immunofluorescence and virus culture. 200 patients were recruited, and 74 (37%) had respiratory viruses detected. For each admitted ARI, the median direct out-of-pocket cost (subsidized) was USD 189 (interquartile range, 140–258), representing a median 16.4% (10.4–22.3%) of reported monthly household income. The median total direct cost (unsubsidized) was USD 756 (564–987), meaning that government subsidies covered a median 75.2% (70.2–78.4%) of actual costs. Median direct costs for 50 respiratory syncytial virus (RSV) cases were higher than the 126 virus-negative cases (USD 803 vs 729, p = 0.03). The median societal cost (combining direct and indirect costs) was USD 871 (653–1,183), which is 1.8 times the Malaysian health expenditure per capita in 2014. Costs were higher with younger age, presence of comorbidity, prematurity, and detection of a respiratory virus. These comprehensive estimated costs of ARI admissions in children < 5 years are high. These costs can be used as a basis for planning treatment and preventive strategies, including cost-effectiveness studies for influenza and, in future, RSV vaccines.
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subjectAmbulatory care ; Caregivers ; Children ; Consumer Price Index ; Cost estimates ; cost of illness ; Costs ; Drug prices ; Economic impact ; Ethnicity ; Expenditures ; Family income ; Generalized linear models ; GNI ; Gross National Income ; Health aspects ; health expenditure ; Health services ; Hospitalization ; Households ; Immunofluorescence ; Infections ; Influenza ; Influenza vaccines ; Interviews ; Laboratories ; Lung diseases ; Malaysia ; Medical care, Cost of ; Medical records ; Morbidity ; Mortality ; Parameter estimation ; Pneumonia ; respiratory infections ; Respiratory syncytial virus ; Social aspects ; Streptococcus infections ; Subsidies ; Subsidies (financial) ; Teaching hospitals ; Vaccines ; Viruses
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description•Median societal cost per admitted acute respiratory infection was USD 803 in 2014.•This cost was 1.8 times the Malaysian health expenditure per capita.•Median out-of-pocket cost was 16% of reported monthly household income.•Children with younger age, comorbidity, and prematurity had higher costs. Acute respiratory infections (ARI) are a major cause of morbidity and mortality in Malaysian children < 5 years. Knowledge of associated economic costs is important for policymakers to determine cost-effectiveness of interventions, such as pneumococcal or influenza vaccines, which are underused in Malaysia. Children < 5 years admitted with ARI to a teaching hospital in Kuala Lumpur were prospectively recruited between July 2013 and July 2015. Medical (with and without government subsidies), non-medical and indirect costs from pre-admission, admission and post-discharge were obtained by interviews with carers and from medical records. Respiratory viruses were diagnosed by immunofluorescence and virus culture. 200 patients were recruited, and 74 (37%) had respiratory viruses detected. For each admitted ARI, the median direct out-of-pocket cost (subsidized) was USD 189 (interquartile range, 140–258), representing a median 16.4% (10.4–22.3%) of reported monthly household income. The median total direct cost (unsubsidized) was USD 756 (564–987), meaning that government subsidies covered a median 75.2% (70.2–78.4%) of actual costs. Median direct costs for 50 respiratory syncytial virus (RSV) cases were higher than the 126 virus-negative cases (USD 803 vs 729, p = 0.03). The median societal cost (combining direct and indirect costs) was USD 871 (653–1,183), which is 1.8 times the Malaysian health expenditure per capita in 2014. Costs were higher with younger age, presence of comorbidity, prematurity, and detection of a respiratory virus. These comprehensive estimated costs of ARI admissions in children < 5 years are high. These costs can be used as a basis for planning treatment and preventive strategies, including cost-effectiveness studies for influenza and, in future, RSV vaccines.
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11Family income
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15Health aspects
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19Households
20Immunofluorescence
21Infections
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28Medical care, Cost of
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30Morbidity
31Mortality
32Parameter estimation
33Pneumonia
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35Respiratory syncytial virus
36Social aspects
37Streptococcus infections
38Subsidies
39Subsidies (financial)
40Teaching hospitals
41Vaccines
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titleSocioeconomic costs of children <5 years hospitalised with acute respiratory infections in Kuala Lumpur, Malaysia
authorSam, I-Ching ; Ahmad Jaafar, Nabeela ; Wong, Li Ping ; Nathan, Anna Marie ; de Bruyne, Jessie Anne ; Chan, Yoke Fun
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10Expenditures
11Family income
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19Households
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32Parameter estimation
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34respiratory infections
35Respiratory syncytial virus
36Social aspects
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atitleSocioeconomic costs of children <5 years hospitalised with acute respiratory infections in Kuala Lumpur, Malaysia
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abstract•Median societal cost per admitted acute respiratory infection was USD 803 in 2014.•This cost was 1.8 times the Malaysian health expenditure per capita.•Median out-of-pocket cost was 16% of reported monthly household income.•Children with younger age, comorbidity, and prematurity had higher costs. Acute respiratory infections (ARI) are a major cause of morbidity and mortality in Malaysian children < 5 years. Knowledge of associated economic costs is important for policymakers to determine cost-effectiveness of interventions, such as pneumococcal or influenza vaccines, which are underused in Malaysia. Children < 5 years admitted with ARI to a teaching hospital in Kuala Lumpur were prospectively recruited between July 2013 and July 2015. Medical (with and without government subsidies), non-medical and indirect costs from pre-admission, admission and post-discharge were obtained by interviews with carers and from medical records. Respiratory viruses were diagnosed by immunofluorescence and virus culture. 200 patients were recruited, and 74 (37%) had respiratory viruses detected. For each admitted ARI, the median direct out-of-pocket cost (subsidized) was USD 189 (interquartile range, 140–258), representing a median 16.4% (10.4–22.3%) of reported monthly household income. The median total direct cost (unsubsidized) was USD 756 (564–987), meaning that government subsidies covered a median 75.2% (70.2–78.4%) of actual costs. Median direct costs for 50 respiratory syncytial virus (RSV) cases were higher than the 126 virus-negative cases (USD 803 vs 729, p = 0.03). The median societal cost (combining direct and indirect costs) was USD 871 (653–1,183), which is 1.8 times the Malaysian health expenditure per capita in 2014. Costs were higher with younger age, presence of comorbidity, prematurity, and detection of a respiratory virus. These comprehensive estimated costs of ARI admissions in children < 5 years are high. These costs can be used as a basis for planning treatment and preventive strategies, including cost-effectiveness studies for influenza and, in future, RSV vaccines.
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pubElsevier Ltd
pmid33931252
doi10.1016/j.vaccine.2021.04.010