Impact of the 13-Valent Conjugated Pneumococcal Vaccine on the Direct Costs of Invasive Pneumococcal Disease Requiring Hospital Admission in Children Aged < 5 Years: A Prospective Study
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Case Selection
2.3. Demographic, Clinical and Epidemiological Variables
2.4. Statistical Analysis
2.5. Economic Analysis
2.6. Data Confidentiality and Ethical Aspects
3. Results
3.1. Health Resources Associated with IPD
3.2. Distribution of the Cost of IPD According to Clinical form and Health Resources
3.3. Annual Evolution of the Costs Associated with IPD
3.4. Variation in the Mean Cost of IPD
3.5. Variation in the Proportion of Costs Associated with Serotypes
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Variable | PCV7 Period 1 (319 Cases) | PCV13 Period 2 (154 Cases) | p Value |
---|---|---|---|
Sex | |||
Female | 148 (46.4%) | 58 (37.7%) | 0.073 |
Male | 171 (53.6%) | 96 (62.3%) | |
Mean age (SD) | 29.6 (15.7) | 26.7 (16.0) | 0.057 |
Clinical presentation | |||
Meningitis | 29 (9.1%) | 18 (11.7%) | 0.273 |
Septic shock | 3 (0.3%) | 4 (2.6%) | 0.222 |
Pneumonia | 254 (79.6%) | 104 (67.5%) | 0.004 |
Non-focal bacteremia | 25 (7.8%) | 16 (10.4%) | 0.355 |
Osteoarticular infection | 6 (1.9%) | 7 (4.5%) | 0.097 |
Mastoiditis | - | 5 (3.2%) | - |
Orbital cellulitis | 2 (0.6%) | - | - |
ICU admission | 44 (13.8%) | 37 (24.0%) | 0.006 |
Median ICU stay (SD) | 0.8 (3.1) | 1.6 (5.5) | 0.086 |
Hospital transfer | 77 (24.1%) | 52 (33.8%) | 0.028 |
Urgent transfer | 11 (3.4%) | 20 (13.0%) | >0.001 |
Non-urgent transfer | 66 (20.7%) | 32 (20.8%) | 0.982 |
Mean days of previous hospitalization (SD) | 0.8 (2.0) | 0.7 (2.2) | 0.587 |
Mean days of high-tech hospital hospitalization (SD) | 9.8 (6.3) | 10.6 (7.5) | 0.226 |
Outpatient treatment | 265 (83.1%) | 124 (80.5%) | 0.496 |
Follow up visits | 0.263 | ||
Primary care | 72 (22.6%) | 42 (27.3%) | |
Specialist | 247 (77.4%) | 112 (72.7%) |
Year (Cases) | 2007 (88) | 2008 (98) | 2009 (133) | 2012 (45) | 2013 (34) | 2014 (35) | 2015 (40) |
---|---|---|---|---|---|---|---|
Days of previous hospitalization | €16,750.4 | €12,723.8 | €11,596.4 | €5959.3 | €4026.5 | €805.3 | €6281.4 |
ICU stay | €58,500.0 | €67,600.0 | €209,300.0 | €75,400.0 | €93,600.0 | €35,100.0 | €122,200.0 |
Days of high technology hospital hospitalization | €160,566.3 | €176,936.4 | €207,238.5 | €80,109.0 | €87,597.5 | €54,334.8 | €62,345.7 |
Days of outpatient antibiotics | €493.1 | €621.5 | €809.3 | €328.7 | €171.9 | €190.2 | €218.6 |
Urgent hospital transfer | €327.0 | €490.6 | €981.1 | €654.1 | €981.1 | €817.6 | €817.6 |
Non-urgent hospital transfer | €1635.2 | €1880.5 | €1880.5 | €899.4 | €735.8 | €327.0 | €654.1 |
Hospital follow-up visits | €7830.0 | €10,461.3 | €11,359.9 | €4043.3 | €3209.0 | €2374.7 | €3979.2 |
Primary care follow-up visits | €660.0 | €390.0 | €1110.0 | €330.0 | €270.0 | €420.0 | €240.0 |
Total | €246,761.9 | €271,104.2 | €444,275.6 | €167,723.8 | €190,591.8 | €94,369.6 | €196,736.5 |
Total per patient | €2804.1 | €2766.4 | €3340.4 | €3728.0 | €5605.6 | €2696.3 | €4981.4 |
Health Resources | Meningitis | Pneumonia | Non-Focal Bacteremia | Other Focal IPD | Total | ||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
PCV7 Period | PCV13 Period | Percent | PCV7 Period | PCV13 Period | % | PCV7 Period | PCV13 Period | Percent | PCV7 Period | PCV13 Period | Percent | PCV7 Period | PCV13 Period | Percent | |
Days of previous hospitalization (SD) | €61.1 (174.4) | €268.4 (665.2) | 339.4% | €154.7 (356.9) | €116.2 (312.9) | −24.9% | €0.0 (0.0) | €0.0 (0.0) | - | €0.0 (0.0) | €10.1 (40.3) | - | €128.7 (329.5) | €110.9 (347.2) | −13.9% |
ICU stay (SD) | €5872.4 (7766.0) | €5272.2 (4356.8) | −10.2% | €501.6 (2915.1) | €1700.0 (8335.9) | 238.9% | €0.0 (0.0) | €325.0 (1300.0) | - | €3427.3 (7674.9) | €650.0 (1424.1) | −81.0% | €1051.4 (4070.2) | €1865.6 (7140.4) | 77.4% |
Days of high-tech hospital hospitalization (SD) | €2474.1 (1871.2) | €3096.0 (1882.8) | 25.1% | €1699.7 (976.8) | €1686.2 (935.9) | −0.8% | €1037.9 (644.7) | €1327.9 (1656.9) | 27.9% | €1393.2 (678.9) | €2002.7 (1500.8) | 43.7% | €1707.6 (1098.0) | €1846.7 (1305.9) | 8.1% |
Days of outpatient antibiotics (SD) | €0.7 (2.3) | €0.7 (2.4) | 3.1% | €6.6 (3.8) | €6.5 (4.9) | −0.5% | €4.9 (3.9) | €4.9 (2.7) | −0.7% | €9.8 (9.8) | €10.1 (6.7) | 3.4% | €6.0 (4.4) | €5.9 (5.3) | 0.6% |
Urgent hospital transfer (SD) | €39.5 (71.2) | €81.8 (84.1) | 107.1% | €1.9 (17.7) | €12.6 (43.8) | 551.3% | €0.0 (0.0) | €0.0 (0.0) | - | €14.9 (49.3) | €30.7 (65.9) | 106.2% | €5.6 (29.9) | €21.2 (55.1) | 276.6% |
Non-urgent hospital transfer (SD) | €0.0 (0.0) | €4.5 (19.3) | - | €20.9 (35.7) | €22.0 (36.4) | 5.2% | €3.3 (16.3) | €5.1 (20.4) | 56.2% | €0.0 (0.0) | €10.2 (27.9) | - | €16.9 (33.2) | €17.0 (33.3) | 0.4% |
Hospital follow-up visits (SD) | €128.4 (0.0) | €128.4 (0.0) | 0.0% | €96.5 (50.6) | €88.9 (55.3) | −7.9% | €0.0 (0.0) | €0.0 (0.0) | - | €128.4 (0.0) | €128.4 (0.0) | 0.0% | €92.9 (53.7) | €88.3 (56.9) | −4.9% |
Primary care follow-up visits (SD) | €0.00 (0.0) | €0.0 (0.0) | - | €5.6 (11.7) | €7.5 (13.0) | 35.1% | €30.0 (0.0) | €30.0 (0.0) | 0.0% | €0.0 (0.0) | €0.0 (0.0) | - | €6.8 (12.6) | €8.2 (13.4) | 20.8% |
Total (SD) | €8576.5 (9114,1) | €8852.0 (5135,7) | 3.2% | €2487.5 (3118.6) | €3639.9 (8522.3) | 46.3% | €1076.1 (648.9) | €1692.9 (2043.7) | 57.3% | €4973.5 (7540.3) | €2842.1 (2256.6) | −42.8% | €3016.1 (4510.2) | €3963.9 (7493.6) | 31.4% |
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Hernández, S.; Navas, E.; Aznar-Lou, I.; Ciruela, P.; García-García, J.J.; Moraga-Llop, F.; Muñoz-Almagro, C.; Codina, G.; F. de Sevilla, M.; González-Peris, S.; et al. Impact of the 13-Valent Conjugated Pneumococcal Vaccine on the Direct Costs of Invasive Pneumococcal Disease Requiring Hospital Admission in Children Aged < 5 Years: A Prospective Study. Vaccines 2020, 8, 387. https://doi.org/10.3390/vaccines8030387
Hernández S, Navas E, Aznar-Lou I, Ciruela P, García-García JJ, Moraga-Llop F, Muñoz-Almagro C, Codina G, F. de Sevilla M, González-Peris S, et al. Impact of the 13-Valent Conjugated Pneumococcal Vaccine on the Direct Costs of Invasive Pneumococcal Disease Requiring Hospital Admission in Children Aged < 5 Years: A Prospective Study. Vaccines. 2020; 8(3):387. https://doi.org/10.3390/vaccines8030387
Chicago/Turabian StyleHernández, Sergi, Encarna Navas, Ignacio Aznar-Lou, Pilar Ciruela, Juan José García-García, Fernando Moraga-Llop, Carmen Muñoz-Almagro, Gemma Codina, Mariona F. de Sevilla, Sebastià González-Peris, and et al. 2020. "Impact of the 13-Valent Conjugated Pneumococcal Vaccine on the Direct Costs of Invasive Pneumococcal Disease Requiring Hospital Admission in Children Aged < 5 Years: A Prospective Study" Vaccines 8, no. 3: 387. https://doi.org/10.3390/vaccines8030387