Socioeconomic costs of children < 5 years hospitalised with acute respiratory infections in Kuala Lumpur, Malaysia
Document Type
Article
Publication Date
5-21-2021
Abstract
Background: Acute respiratory infections (ARI) are a major cause of morbidity and mortality in Malaysian children < 5 years. Knowledge of associated economic costs is important for policymakers to determine cost-effectiveness of interventions, such as pneumococcal or influenza vaccines, which are underused in Malaysia. Methods: Children < 5 years admitted with ARI to a teaching hospital in Kuala Lumpur were prospectively recruited between July 2013 and July 2015. Medical (with and without government subsidies), nonmedical and indirect costs from pre-admission, admission and post-discharge were obtained by interviews with carers and from medical records. Respiratory viruses were diagnosed by immunofluorescence and virus culture. Results: 200 patients were recruited, and 74 (37%) had respiratory viruses detected. For each admitted ARI, the median direct out-of-pocket cost (subsidized) was USD 189 (interquartile range, 140-258), representing a median 16.4% (10.4-22.3%) of reported monthly household income. The median total direct cost (unsubsidized) was USD 756 (564-987), meaning that government subsidies covered a median 75.2% (70.2-78.4%) of actual costs. Median direct costs for 50 respiratory syncytial virus (RSV) cases were higher than the 126 virus-negative cases (USD 803 vs 729, p = 0.03). The median societal cost (combining direct and indirect costs) was USD 871 (653-1,183), which is 1.8 times the Malaysian health expenditure per capita in 2014. Costs were higher with younger age, presence of comorbidity, prematurity, and detection of a respiratory virus. Conclusion: These comprehensive estimated costs of ARI admissions in children < 5 years are high. These costs can be used as a basis for planning treatment and preventive strategies, including cost-effectiveness studies for influenza and, in future, RSV vaccines. (c) 2021 Elsevier Ltd. All rights reserved.
Keywords
Health expenditure, Cost of illness, Respiratory syncytial virus, Respiratory infections, Children, Malaysia
Divisions
fac_med
Funders
SanofiAventis (Malaysia) [FLU29EXT/55-0203-1069],Universiti Malaya [UM.C/625/1/HIR/MOHE/MED/42]
Publication Title
Vaccine
Volume
39
Issue
22
Publisher
Elsevier Sci Ltd
Publisher Location
THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND