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

Sam, I-Ching and Jaafar, Nabeela Ahmad and Wong, Li Ping and Nathan, Anna Marie and de Bruyne, Jessie Anne and Chan, Yoke Fun (2021) Socioeconomic costs of children < 5 years hospitalised with acute respiratory infections in Kuala Lumpur, Malaysia. Vaccine, 39 (22). pp. 2983-2988. ISSN 0264-410X, DOI

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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.

Item Type: Article
Funders: SanofiAventis (Malaysia) [FLU29EXT/55-0203-1069], Universiti Malaya [UM.C/625/1/HIR/MOHE/MED/42]
Uncontrolled Keywords: Health expenditure; Cost of illness; Respiratory syncytial virus; Respiratory infections; Children; Malaysia
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Medicine
Depositing User: Ms Zaharah Ramly
Date Deposited: 13 Aug 2022 05:17
Last Modified: 13 Aug 2022 05:17

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