NDLI: Rates and costs of invasive pneumococcal disease and pneumonia in persons with underlying medical conditions

Content Provider	Springer Nature : BioMed Central
Author	Weycker, Derek Farkouh, Raymond A. Strutton, David R. Edelsberg, John Shea, Kimberly M. Pelton, Stephen I.
Abstract	Background The presence of certain underlying medical conditions is known to increase the risk of pneumococcal disease in persons of all ages and across a wide spectrum of conditions, as demonstrated in two recent evaluations. Corresponding estimates of attributable economic costs have not been well characterized. We thus undertook a retrospective evaluation to estimate rates and costs of pneumococcal disease among children and adults with and without underlying medical conditions in the United States. Methods Data were obtained from three independent healthcare claims repositories. The study population included all persons enrolled in participating health plans during 2007–2010, and was stratified into subgroups based on age and risk profile: healthy; at-risk, due to selected comorbid conditions; and high-risk, due to selected immunocompromising conditions. At-risk and high-risk conditions, as well as episodes of invasive pneumococcal disease (IPD) and all-cause pneumonia (PNE), were identified via diagnosis, procedure, and drug codes. Rates and healthcare costs of IPD and PNE (2010US$) among at-risk and high-risk persons were compared with those from age-stratified healthy counterparts using incidence rate ratios (IRR) and cost ratios. Results Rates of IPD and PNE were consistently higher among at-risk persons (IRR = 4.1 [95 % CI 3.9–4.3] and 4.5 [4.49–4.53]) and high-risk persons (IRR = 10.3 [9.7–11.0] and 8.2 [8.2–8.3]) of all ages versus their healthy counterparts. Rates were notably high for at-risk persons with ≥2 conditions (IRR = 9.0 [8.4–9.7] and 10.3 [10.3–10.4]), as well as those with asthma (IRR = 3.4 [3.0–3.8] and 4.5 [4.47–4.53]) or diabetes (IRR = 4.3 [4.0–4.6] and 4.7 [4.6–4.7]). Healthcare costs totaled $21.7 million per 100,000 at-risk person-years and $58.5 million per 100,000 high-risk person-years, which were 8.7 [8.5–8.8] and 23.4 [22.9–23.8] times higher than corresponding costs for healthy persons. Conclusions Rates and costs of IPD and PNE are substantially higher among persons with certain chronic and immunocompromising conditions versus those without any such conditions. Rates and costs for persons with asthma and diabetes were especially increased, and rates and costs for individuals with ≥2 at-risk conditions approached those among persons with high-risk conditions.
Related Links	https://bmchealthservres.biomedcentral.com/counter/pdf/10.1186/s12913-016-1432-4.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
ISSN	14726963
DOI	10.1186/s12913-016-1432-4
Journal	BMC Health Services Research
Issue Number	1
Volume Number	16
Language	English
Publisher	BioMed Central
Publisher Date	2016-05-13
Access Restriction	Open
Subject Keyword	Public Health Health Administration Health Informatics Nursing Research Streptococcus pneumoniae Pneumococcal infections Pneumonia Comorbidity Cost and cost analysis
Content Type	Text
Resource Type	Article
Subject	Health Policy

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
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