Economic burden of influenza-associated hospitalizations and outpatient visits in Bangladesh during 2010

Mejbah U Bhuiyan; Stephen P Luby; Nadia I Alamgir; Nusrat Homaira; Abdullah A Mamun; Jahangir A M Khan; Jaynal Abedin; Katharine Sturm-Ramirez; Emily S Gurley; Rashid U Zaman; A S M Alamgir; Mahmudur Rahman; Marc-Alain Widdowson; Eduardo Azziz-Baumgartner

doi:10.1111/irv.12254

Economic burden of influenza-associated hospitalizations and outpatient visits in Bangladesh during 2010

Mejbah U Bhuiyan, Stephen P Luby, Nadia I Alamgir, Nusrat Homaira, Abdullah A Mamun, Jahangir A M Khan, Jaynal Abedin, Katharine Sturm-Ramirez, Emily S Gurley, Rashid U Zaman, A S M Alamgir, Mahmudur Rahman, Marc-Alain Widdowson, Eduardo Azziz-Baumgartner

Institute of Tropical Medicine

Research output: Contribution to journal › A1: Web of Science-article › peer-review

Abstract

OBJECTIVE: Understanding the costs of influenza-associated illness in Bangladesh may help health authorities assess the cost-effectiveness of influenza prevention programs. We estimated the annual economic burden of influenza-associated hospitalizations and outpatient visits in Bangladesh.

DESIGN: From May through October 2010, investigators identified both outpatients and inpatients at four tertiary hospitals with laboratory-confirmed influenza infection through rRT-PCR. Research assistants visited case-patients' homes within 30 days of hospital visit/discharge and administered a structured questionnaire to capture direct medical costs (physician consultation, hospital bed, medicines and diagnostic tests), direct non-medical costs (food, lodging and travel) and indirect costs (case-patients' and caregivers' lost income). We used WHO-Choice estimates for routine healthcare service costs. We added direct, indirect and healthcare service costs to calculate cost-per-episode. We used median cost-per-episode, published influenza-associated outpatient and hospitalization rates and Bangladesh census data to estimate the annual economic burden of influenza-associated illnesses in 2010.

RESULTS: We interviewed 132 outpatients and 41 hospitalized patients. The median cost of an influenza-associated outpatient visit was US$4.80 (IQR = 2.93-8.11) and an influenza-associated hospitalization was US$82.20 (IQR = 59.96-121.56). We estimated that influenza-associated outpatient visits resulted in US$108 million (95% CI: 76-147) in direct costs and US$59 million (95% CI: 37-91) in indirect costs; influenza-associated hospitalizations resulted in US$1.4 million (95% CI: 0.4-2.6) in direct costs and US$0.4 million (95% CI: 0.1-0.8) in indirect costs in 2010.

CONCLUSIONS: In Bangladesh, influenza-associated illnesses caused an estimated US$169 million in economic loss in 2010, largely driven by frequent but low-cost outpatient visits.

Original language	English
Journal	Influenza and Other Respiratory Viruses
Volume	8
Issue number	4
Pages (from-to)	406-413
Number of pages	8
ISSN	1750-2640
DOIs	https://doi.org/10.1111/irv.12254
Publication status	Published - 2014

Keywords

Adolescent
Adult
Ambulatory Care/economics
Bangladesh/epidemiology
Child
Child, Preschool
Female
Health Expenditures/statistics & numerical data
Hospitalization/economics
Humans
Infant
Infant, Newborn
Influenza, Human/economics
Male
Middle Aged
Orthomyxoviridae/isolation & purification
Reverse Transcriptase Polymerase Chain Reaction
Surveys and Questionnaires
Young Adult

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10.1111/irv.12254

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Bhuiyan, M. U., Luby, S. P., Alamgir, N. I., Homaira, N., Mamun, A. A., Khan, J. A. M., Abedin, J., Sturm-Ramirez, K., Gurley, E. S., Zaman, R. U., Alamgir, A. S. M., Rahman, M., Widdowson, M.-A., & Azziz-Baumgartner, E. (2014). Economic burden of influenza-associated hospitalizations and outpatient visits in Bangladesh during 2010. Influenza and Other Respiratory Viruses, 8(4), 406-413. https://doi.org/10.1111/irv.12254

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title = "Economic burden of influenza-associated hospitalizations and outpatient visits in Bangladesh during 2010",

abstract = "OBJECTIVE: Understanding the costs of influenza-associated illness in Bangladesh may help health authorities assess the cost-effectiveness of influenza prevention programs. We estimated the annual economic burden of influenza-associated hospitalizations and outpatient visits in Bangladesh.DESIGN: From May through October 2010, investigators identified both outpatients and inpatients at four tertiary hospitals with laboratory-confirmed influenza infection through rRT-PCR. Research assistants visited case-patients' homes within 30 days of hospital visit/discharge and administered a structured questionnaire to capture direct medical costs (physician consultation, hospital bed, medicines and diagnostic tests), direct non-medical costs (food, lodging and travel) and indirect costs (case-patients' and caregivers' lost income). We used WHO-Choice estimates for routine healthcare service costs. We added direct, indirect and healthcare service costs to calculate cost-per-episode. We used median cost-per-episode, published influenza-associated outpatient and hospitalization rates and Bangladesh census data to estimate the annual economic burden of influenza-associated illnesses in 2010.RESULTS: We interviewed 132 outpatients and 41 hospitalized patients. The median cost of an influenza-associated outpatient visit was US$4.80 (IQR = 2.93-8.11) and an influenza-associated hospitalization was US$82.20 (IQR = 59.96-121.56). We estimated that influenza-associated outpatient visits resulted in US$108 million (95% CI: 76-147) in direct costs and US$59 million (95% CI: 37-91) in indirect costs; influenza-associated hospitalizations resulted in US$1.4 million (95% CI: 0.4-2.6) in direct costs and US$0.4 million (95% CI: 0.1-0.8) in indirect costs in 2010.CONCLUSIONS: In Bangladesh, influenza-associated illnesses caused an estimated US$169 million in economic loss in 2010, largely driven by frequent but low-cost outpatient visits.",

keywords = "Adolescent, Adult, Ambulatory Care/economics, Bangladesh/epidemiology, Child, Child, Preschool, Female, Health Expenditures/statistics & numerical data, Hospitalization/economics, Humans, Infant, Infant, Newborn, Influenza, Human/economics, Male, Middle Aged, Orthomyxoviridae/isolation & purification, Reverse Transcriptase Polymerase Chain Reaction, Surveys and Questionnaires, Young Adult",

author = "Bhuiyan, {Mejbah U} and Luby, {Stephen P} and Alamgir, {Nadia I} and Nusrat Homaira and Mamun, {Abdullah A} and Khan, {Jahangir A M} and Jaynal Abedin and Katharine Sturm-Ramirez and Gurley, {Emily S} and Zaman, {Rashid U} and Alamgir, {A S M} and Mahmudur Rahman and Marc-Alain Widdowson and Eduardo Azziz-Baumgartner",

note = "{\textcopyright} 2014 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.",

year = "2014",

doi = "10.1111/irv.12254",

language = "English",

volume = "8",

pages = "406--413",

journal = "Influenza and Other Respiratory Viruses",

issn = "1750-2640",

publisher = "John Wiley & Sons",

number = "4",

}

Bhuiyan, MU, Luby, SP, Alamgir, NI, Homaira, N, Mamun, AA, Khan, JAM, Abedin, J, Sturm-Ramirez, K, Gurley, ES, Zaman, RU, Alamgir, ASM, Rahman, M, Widdowson, M-A & Azziz-Baumgartner, E 2014, 'Economic burden of influenza-associated hospitalizations and outpatient visits in Bangladesh during 2010', Influenza and Other Respiratory Viruses, vol. 8, no. 4, pp. 406-413. https://doi.org/10.1111/irv.12254

TY - JOUR

T1 - Economic burden of influenza-associated hospitalizations and outpatient visits in Bangladesh during 2010

AU - Bhuiyan, Mejbah U

AU - Luby, Stephen P

AU - Alamgir, Nadia I

AU - Homaira, Nusrat

AU - Mamun, Abdullah A

AU - Khan, Jahangir A M

AU - Abedin, Jaynal

AU - Sturm-Ramirez, Katharine

AU - Gurley, Emily S

AU - Zaman, Rashid U

AU - Alamgir, A S M

AU - Rahman, Mahmudur

AU - Widdowson, Marc-Alain

AU - Azziz-Baumgartner, Eduardo

PY - 2014

Y1 - 2014

N2 - OBJECTIVE: Understanding the costs of influenza-associated illness in Bangladesh may help health authorities assess the cost-effectiveness of influenza prevention programs. We estimated the annual economic burden of influenza-associated hospitalizations and outpatient visits in Bangladesh.DESIGN: From May through October 2010, investigators identified both outpatients and inpatients at four tertiary hospitals with laboratory-confirmed influenza infection through rRT-PCR. Research assistants visited case-patients' homes within 30 days of hospital visit/discharge and administered a structured questionnaire to capture direct medical costs (physician consultation, hospital bed, medicines and diagnostic tests), direct non-medical costs (food, lodging and travel) and indirect costs (case-patients' and caregivers' lost income). We used WHO-Choice estimates for routine healthcare service costs. We added direct, indirect and healthcare service costs to calculate cost-per-episode. We used median cost-per-episode, published influenza-associated outpatient and hospitalization rates and Bangladesh census data to estimate the annual economic burden of influenza-associated illnesses in 2010.RESULTS: We interviewed 132 outpatients and 41 hospitalized patients. The median cost of an influenza-associated outpatient visit was US$4.80 (IQR = 2.93-8.11) and an influenza-associated hospitalization was US$82.20 (IQR = 59.96-121.56). We estimated that influenza-associated outpatient visits resulted in US$108 million (95% CI: 76-147) in direct costs and US$59 million (95% CI: 37-91) in indirect costs; influenza-associated hospitalizations resulted in US$1.4 million (95% CI: 0.4-2.6) in direct costs and US$0.4 million (95% CI: 0.1-0.8) in indirect costs in 2010.CONCLUSIONS: In Bangladesh, influenza-associated illnesses caused an estimated US$169 million in economic loss in 2010, largely driven by frequent but low-cost outpatient visits.

AB - OBJECTIVE: Understanding the costs of influenza-associated illness in Bangladesh may help health authorities assess the cost-effectiveness of influenza prevention programs. We estimated the annual economic burden of influenza-associated hospitalizations and outpatient visits in Bangladesh.DESIGN: From May through October 2010, investigators identified both outpatients and inpatients at four tertiary hospitals with laboratory-confirmed influenza infection through rRT-PCR. Research assistants visited case-patients' homes within 30 days of hospital visit/discharge and administered a structured questionnaire to capture direct medical costs (physician consultation, hospital bed, medicines and diagnostic tests), direct non-medical costs (food, lodging and travel) and indirect costs (case-patients' and caregivers' lost income). We used WHO-Choice estimates for routine healthcare service costs. We added direct, indirect and healthcare service costs to calculate cost-per-episode. We used median cost-per-episode, published influenza-associated outpatient and hospitalization rates and Bangladesh census data to estimate the annual economic burden of influenza-associated illnesses in 2010.RESULTS: We interviewed 132 outpatients and 41 hospitalized patients. The median cost of an influenza-associated outpatient visit was US$4.80 (IQR = 2.93-8.11) and an influenza-associated hospitalization was US$82.20 (IQR = 59.96-121.56). We estimated that influenza-associated outpatient visits resulted in US$108 million (95% CI: 76-147) in direct costs and US$59 million (95% CI: 37-91) in indirect costs; influenza-associated hospitalizations resulted in US$1.4 million (95% CI: 0.4-2.6) in direct costs and US$0.4 million (95% CI: 0.1-0.8) in indirect costs in 2010.CONCLUSIONS: In Bangladesh, influenza-associated illnesses caused an estimated US$169 million in economic loss in 2010, largely driven by frequent but low-cost outpatient visits.

KW - Adolescent

KW - Adult

KW - Ambulatory Care/economics

KW - Bangladesh/epidemiology

KW - Child

KW - Child, Preschool

KW - Female

KW - Health Expenditures/statistics & numerical data

KW - Hospitalization/economics

KW - Humans

KW - Infant

KW - Infant, Newborn

KW - Influenza, Human/economics

KW - Male

KW - Middle Aged

KW - Orthomyxoviridae/isolation & purification

KW - Reverse Transcriptase Polymerase Chain Reaction

KW - Surveys and Questionnaires

KW - Young Adult

U2 - 10.1111/irv.12254

DO - 10.1111/irv.12254

M3 - A1: Web of Science-article

C2 - 24750586

SN - 1750-2640

VL - 8

SP - 406

EP - 413

JO - Influenza and Other Respiratory Viruses

JF - Influenza and Other Respiratory Viruses

IS - 4

ER -

Economic burden of influenza-associated hospitalizations and outpatient visits in Bangladesh during 2010

Abstract

Keywords

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