Estimates of economic burden of providing inpatient care in childhood rotavirus gastroenteritis from Malaysia

Lee, Way Seah; Poo, Muhammad Izzuddin; Nagaraj, Shyamala

doi:10.1111/j.1440-1754.2007.01160.x

Cited by 16 publications

(13 citation statements)

References 24 publications

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“…Our estimation of hospitalization costs per patient (Table 3) is generally higher than published estimates from countries of similar economic status based on GDP per capita, including Vietnam [4], Indonesia [73], and Kyrgyzstan [37]. Our estimate was most similar to published estimates of hospitalization costs in Peru ($284.08) [36] and Malaysia ($187.72) [20], both of which have a higher economic status than Bolivia. As expected, hospitalizations exhibited a larger reduction in events (Table 4) and costs (data not shown) than outpatient visits due to the rotavirus vaccine.…”

Section: Discussionsupporting

confidence: 71%

Cost-effectiveness of rotavirus vaccination in Bolivia from the state perspective

Smith

Rowlinson

Iñiguez

et al. 2011

Vaccine

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BACKGROUND In Bolivia, in 2008, the under-five mortality rate is 54 per 1000 live births. Diarrhea causes 15% of these deaths, and 40% of pediatric diarrhea-related hospitalizations are caused by rotavirus illness (RI). Rotavirus vaccination (RV), subsidized by international donors, is expected to reduce morbidity, mortality, and economic burden to the Bolivian state. Estimates of illness and economic burden of RI and their reduction by RV are essential to the Bolivian state’s policies on RV program financing. The goal of this report is to estimate the economic burden of RI and the cost-effectiveness of the RV program. METHODS To assess treatment costs incurred by the healthcare system, we abstracted medical records from 287 inpatients and 6,751 outpatients with acute diarrhea between 2005 and 2006 at 5 sentinel hospitals in 4 geographic regions. RI prevalence rates were estimated from 4 years of national hospital surveillance. We used a decision-analytic model to assess the potential cost-effectiveness of universal RV in Bolivia. RESULTS Our model estimates that, in a 5-year birth cohort, Bolivia will incur over US$3 million in direct medical costs due to RI. RV reduces, by at least 60%, outpatient visits, hospitalizations, deaths, and total direct medical costs associated with rotavirus diarrhea. Further, RV was cost-savings below a price of US$3.81 per dose and cost-effective below a price of US$194.10 per dose. Diarrheal mortality and hospitalization inputs were the most important drivers of rotavirus vaccine cost-effectiveness. DISCUSSION Our data will guide Bolivia’s funding allocation for RV as international subsidies change.

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Section: Discussionsupporting

confidence: 71%

Cost-effectiveness of rotavirus vaccination in Bolivia from the state perspective

Smith

Rowlinson

Iñiguez

et al. 2011

Vaccine

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“…Costs of supporting departments (e.g. administration) were not included [ 23 ]. Another study conducted in Malaysia during August 2006 and July 2007 measured out-of-pocket costs [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Cost of rotavirus diarrhea for programmatic evaluation of vaccination in Vietnam

Riewpaiboon

Shin

et al. 2016

BMC Public Health

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BackgroundRotavirus is the most common etiology of diarrhea-associated hospitalizations and clinic visits in Vietnamese children < 5 years old. To estimate the economic burden of rotavirus-associated formal healthcare encounters, an economic study was conducted.MethodsA cost-of-illness study was performed from a societal perspective. Data were collected from children below the age of five years who presented to a clinic or hospital with symptoms of acute gastroenteritis (AGE). Patient-specific information on resource use and cost was obtained through caregiver interviews and medical chart review. Costs are presented in 2014 US dollar ($).ResultsA total of 557 children with symptoms of AGE were enrolled from March through June 2009, with mean age of 16.5 months. Of the 340 outpatients and 217 admitted patients enrolled, 41 % tested rotavirus positive. It was found that, from a societal perspective, the mean total cost of AGE was $175. Costs of patients with and without rotavirus were $217 and $158, respectively. From multiple regression analysis, it was found that rotavirus infection, patient age and receiving oral rehydration solution before visiting health facility had significant effect on the costs.ConclusionsThis study clearly demonstrated substantial economic burden of AGE including rotavirus disease. They were significantly greater than the previously reported cost estimates in Vietnam. These updated costs of illness result in more favorable vaccine cost-effectiveness than in previous economic evaluations.

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“…In 2005, it was estimated that by the age of five years, 1 in 37 children will visit a clinic, 1 in 61 children will be hospitalized, and 1 in 15,000 children will die as a result of RVGE [ 2 ]. The estimated median cost of providing inpatient care for an episode RVGE was US$212 (range US$69–881) in 2002 [ 3 ]. In 2009, the mean cost incurred by households for an episode of RVGE requiring hospitalization was estimated at US$194 (range US$47–738), constituting 26% of the average monthly household income [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Household Catastrophic Healthcare Expenditure and Impoverishment Due to Rotavirus Gastroenteritis Requiring Hospitalization in Malaysia

Loganathan

Lee

et al. 2015

PLoS ONE

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BackgroundWhile healthcare costs for rotavirus gastroenteritis requiring hospitalization may be burdensome on households in Malaysia, exploration on the distribution and catastrophic impact of these expenses on households are lacking.ObjectivesWe assessed the economic burden, levels and distribution of catastrophic healthcare expenditure, the poverty impact on households and inequities related to healthcare payments for acute gastroenteritis requiring hospitalization in Malaysia.MethodsA two-year prospective, hospital-based study was conducted from 2008 to 2010 in an urban (Kuala Lumpur) and rural (Kuala Terengganu) setting in Malaysia. All children under the age of 5 years admitted for acute gastroenteritis were included. Patients were screened for rotavirus and information on healthcare expenditure was obtained.ResultsOf the 658 stool samples collected at both centers, 248 (38%) were positive for rotavirus. Direct and indirect costs incurred were significantly higher in Kuala Lumpur compared with Kuala Terengganu (US$222 Vs. US$45; p<0.001). The mean direct and indirect costs for rotavirus gastroenteritis consisted 20% of monthly household income in Kuala Lumpur, as compared with only 5% in Kuala Terengganu. Direct medical costs paid out-of-pocket caused 141 (33%) households in Kuala Lumpur to experience catastrophic expenditure and 11 (3%) households to incur poverty. However in Kuala Terengganu, only one household (0.5%) experienced catastrophic healthcare expenditure and none were impoverished. The lowest income quintile in Kuala Lumpur was more likely to experience catastrophic payments compared to the highest quintile (87% vs 8%). The concentration index for out-of-pocket healthcare payments was closer to zero at Kuala Lumpur (0.03) than at Kuala Terengganu (0.24).ConclusionsWhile urban households were wealthier, healthcare expenditure due to gastroenteritis had more catastrophic and poverty impact on the urban poor. Universal rotavirus vaccination would reduce both disease burden and health inequities in Malaysia.

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Estimates of economic burden of providing inpatient care in childhood rotavirus gastroenteritis from Malaysia

Abstract: The cost of providing inpatient care for childhood rotavirus GE in Malaysia was estimated to be US$1.8 million annually. The financial burden of rotavirus disease would be higher if cost of outpatient visits, non-medical and societal costs are included.

Cited by 16 publications

References 24 publications

Cost-effectiveness of rotavirus vaccination in Bolivia from the state perspective

Cost-effectiveness of rotavirus vaccination in Bolivia from the state perspective

Cost of rotavirus diarrhea for programmatic evaluation of vaccination in Vietnam

Household Catastrophic Healthcare Expenditure and Impoverishment Due to Rotavirus Gastroenteritis Requiring Hospitalization in Malaysia

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