Socioeconomic costs of children <5 years hospitalised with acute respiratory infections in Kuala Lumpur, Malaysia.

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), non-medical 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.

• Authors: I-Ching Sam, Nabeela Ahmad Jaafar, Li Ping Wong, Anna Marie Nathan, Jessie Anne de Bruyne, Yoke Fun Chan
• Journal: Vaccine (Vaccine) Vol. 39 Issue 22 Pg. 2983-2988 (05 21 2021) ISSN: 1873-2518 [Electronic] Netherlands
• PMID: 33931252 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2021 Elsevier Ltd. All rights reserved.

Topics

• Aftercare
• Child
• Hospitalization
• Humans
• Infant
• Malaysia (epidemiology)
• Patient Discharge
• Respiratory Syncytial Virus Infections (epidemiology)
• Respiratory Tract Infections (epidemiology)
• Socioeconomic Factors