Clinical and economic impact of pneumonia and acute respiratory infection related with influenza vaccination in diabetic patients or patients with chronic obstructive pulmonary disease in Colombia, 2013-2016

Abstract

Background Influenza is a public health problem and has important outcomes in at-risk populations such as children, pregnant women, chronic patients, and the elderly. The influenza vaccine has demonstrated to be effective in these groups and is indicated in the Colombian health policy. Chronic patients with highly prevalent diseases in middle and late adulthood such as type 2 diabetes mellitus (DM) and chronic obstructive pulmonary disease (COPD) require special attention for influenza vaccination. The aim was: assess the frequency of hospitalizations and consultations related to respiratory diseases, as well as number of deaths due to pneumonia in subjects with DM or COPD, comparing those who received the influenza vaccine against those who did not receive it retrospectively over the years 2013 to 2016, and the economic impact thereof for the health system in Colombia. Methodology: An analysis of a retrospective cohort from 2013 to 2016 of diabetic or COPD patients was performed, assessing national information on annual vaccination coverage, and the vaccinated and unvaccinated populations were adjusted through a Propensity Score Matching (PSM) for each chronic disease, the frequency of hospitalizations, consultations due to respiratory (any etiology) and mortality rates for pneumonia. The main source of information was the Individual Health Services Provision Records (RIPS), vaccination data from the Expanded Program on Immunization (EPI) and mortality data from the National Administrative Department of Statistics (DANE). The process of analysis was validated by the Ministry of Health and Social Protection. Results There was a reduction of about 50% in the number of pneumonia hospitalizations of vaccinated chronic patients with DM and COPD compared to unvaccinated patients, which translates into lower economic impact costs, with potential savings of about USD $1.1 to $2.3 million for COPD, and between USD $265 thousand and USD $504 thousand for DM. Conclusion Vaccination against influenza in chronic patients with DM or COPD avoids hospitalizations and deaths from pneumonia, which translates into significant potential savings for the Colombian health system.