Healthcare utilization and cost of Stevens-Johnson syndrome and toxic epidermal necrolysis management in Thailand

Abstract

Background:Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are life-threatening dermatologic conditions. Although, the incidence of SJS/TEN in Thailand is high, information on cost of care for SJS/TEN is limited. This study aims to estimate healthcare resource utilization and cost of SJS/TEN in Thailand, using hospital perspective.Methods:A retrospective study using an electronic health database from a university-affiliated hospital in Thailand was undertaken. Patients admitted with SJS/TEN from 2002 to 2007 were included. Direct medical cost was estimated by the cost-to-charge ratio. Cost was converted to 2013 value by consumer price index, and converted to $US using 31 Baht/1 $US. The healthcare resource utilization was also estimated.Results:A total of 157 patients were included with average age of 45.3±23.0 years. About 146 patients (93.0%) were diagnosed as SJS and the remaining (7.0%) were diagnosed as TEN. Most of the patients (83.4%) were treated with systemic corticosteroids. Overall, mortality rate was 8.3%, while the average length of stay (LOS) was 10.1±13.2 days. The average cost of managing SJS/TEN for all patients was $1,064±$2,558. The average cost for SJS patients was $1,019±$2,601 while that for TEN patients was $1,660±$1,887.Conclusions:Healthcare resource utilization and cost of care for SJS/TEN in Thailand were tremendous. The findings are important for policy makers to allocate healthcare resources and develop strategies to prevent SJS/TEN which could decrease length of stay and cost of care.

Incidence, causative drugs, and economic consequences of drug-induced SJS, TEN, and SJS–TEN overlap and potential drug–drug interactions during treatment: a retrospective analysis at an Indonesian referral hospital

“…This finding could be explained by the fact that 8 of 15 TEN patients were died within a short period of time, thus resulting in a shorter average hospital stay than SJS–TEN patients. This result is in line with the latest study from Thailand 29. In contrast to the average hospital stay in this study, TEN patients had the highest COI of the patients studied.…”

“…This result is in line with the latest study from Thailand. 29 In contrast to the average hospital stay in this study, TEN patients had the highest COI of the patients studied. This result is probably because TEN patients were likely to be more complicated recoveries than SJS and SJS–TEN patients.…”

Clinical Features and Treatment Outcomes among Children with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A 20-Year Study in a Tertiary Referral Hospital

“…The mortality rate is high for SJS and significantly higher for TEN. The reported mortality rate in the Thai population was 7–50% [3] which is quite higher relative to other countries [4, 5]. …”

Evaluasi Biaya Medis Langsung Pada Pasien Stevens Johnson Syndrome Di Rsup Dr. Sardjito Yogyakarta

“…Sedangkan biaya paling kecil pada SJS adalah biaya administrasi sebesar 0,35% dari total biaya medik langsung pasien SJS. (Dilokthornsakul et al, 2016).…”