Costs of hospitalization with respiratory syncytial virus illness among children aged < 5 years and the financial impact on households in Bangladesh, 2010

Mejbah Uddin Bhuiyan, Stephen P. Luby, Nadia Ishrat Alamgir, Nusrat Homaira, Katharine Sturm-Ramirez, Emily S. Gurley, Jaynal Abedin, Rashid Uz Zaman, A. S.M. Alamgir, Mahmudur Rahman, Ismael R. Ortega-Sanchez, Eduardo Azziz-Baumgartner

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    Abstract

    Background Respiratory syncytial virus (RSV) is the leading cause of acute respiratory illness in young children and results in significant economic burden. There is no vaccine to prevent RSV illness but a number of vaccines are in development. We conducted this study to estimate the costs of severe RSV illness requiring hospitalization among children <5 years and associated financial impact on households in Bangladesh. Data of this study could be useful for RSV vaccine development and also the value of various preventive strategies, including use of an RSV vaccine in children if one becomes available. Methods From May through October 2010, children aged < 5 years with laboratory-confirmed RSV were identified from a sentinel influenza program database at four tertiary hospitals. Research assistants visited case-patients' homes after hospital discharge and administered a structured questionnaire to record direct medical costs (physician consultation fee, costs for hospital bed, medicines and diagnostic tests); non-medical costs (costs for food, lodging and transportation); indirect costs (caregivers' productivity loss), and coping strategies used by families to pay for treatment. We used WHO-Choice estimates for routine health care service costs. We added direct, indirect and health care service costs to calculate cost-per-episode of severe RSV illness. We used Monte Carlo simulation to estimate annual economic burden for severe RSV illness. Findings We interviewed caregivers of 39 persons hospitalized for RSV illness. The median direct cost for hospitalization was US$ 62 (interquartile range [IQR] = 43-101), indirect cost was US$ 19 (IQR = 11-29) and total cost was US$ 94 (IQR = 67-127). The median out-of-pocket cost was 24% of monthly household income of affected families (US$ 143), and > 50% families borrowed money to meet treatment cost. We estimated that the median direct cost of RSV-associated hospitalization in children aged < 5 years in Bangladesh was US$ 10 million (IQR: US$ 7-16 million), the median indirect cost was US$ 3.0 million (IQR: 2-5 million) in 2010. Conclusion: RSV-associated hospitalization among children aged < 5 years represents a substantial economic burden in Bangladesh. Affected families frequently incurred considerable out of pocket and indirect costs for treatment that resulted in financial hardship.

    Original languageEnglish
    Article number010412
    JournalJournal of Global Health
    Volume7
    Issue number1
    DOIs
    Publication statusPublished - 13 Jun 2017

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    Respiratory Syncytial Viruses
    Bangladesh
    Hospitalization
    Costs and Cost Analysis
    Vaccines
    Economics
    Health Expenditures
    Health Care Costs

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    Bhuiyan, Mejbah Uddin ; Luby, Stephen P. ; Alamgir, Nadia Ishrat ; Homaira, Nusrat ; Sturm-Ramirez, Katharine ; Gurley, Emily S. ; Abedin, Jaynal ; Zaman, Rashid Uz ; Alamgir, A. S.M. ; Rahman, Mahmudur ; Ortega-Sanchez, Ismael R. ; Azziz-Baumgartner, Eduardo. / Costs of hospitalization with respiratory syncytial virus illness among children aged < 5 years and the financial impact on households in Bangladesh, 2010. In: Journal of Global Health. 2017 ; Vol. 7, No. 1.
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    title = "Costs of hospitalization with respiratory syncytial virus illness among children aged < 5 years and the financial impact on households in Bangladesh, 2010",
    abstract = "Background Respiratory syncytial virus (RSV) is the leading cause of acute respiratory illness in young children and results in significant economic burden. There is no vaccine to prevent RSV illness but a number of vaccines are in development. We conducted this study to estimate the costs of severe RSV illness requiring hospitalization among children <5 years and associated financial impact on households in Bangladesh. Data of this study could be useful for RSV vaccine development and also the value of various preventive strategies, including use of an RSV vaccine in children if one becomes available. Methods From May through October 2010, children aged < 5 years with laboratory-confirmed RSV were identified from a sentinel influenza program database at four tertiary hospitals. Research assistants visited case-patients' homes after hospital discharge and administered a structured questionnaire to record direct medical costs (physician consultation fee, costs for hospital bed, medicines and diagnostic tests); non-medical costs (costs for food, lodging and transportation); indirect costs (caregivers' productivity loss), and coping strategies used by families to pay for treatment. We used WHO-Choice estimates for routine health care service costs. We added direct, indirect and health care service costs to calculate cost-per-episode of severe RSV illness. We used Monte Carlo simulation to estimate annual economic burden for severe RSV illness. Findings We interviewed caregivers of 39 persons hospitalized for RSV illness. The median direct cost for hospitalization was US$ 62 (interquartile range [IQR] = 43-101), indirect cost was US$ 19 (IQR = 11-29) and total cost was US$ 94 (IQR = 67-127). The median out-of-pocket cost was 24{\%} of monthly household income of affected families (US$ 143), and > 50{\%} families borrowed money to meet treatment cost. We estimated that the median direct cost of RSV-associated hospitalization in children aged < 5 years in Bangladesh was US$ 10 million (IQR: US$ 7-16 million), the median indirect cost was US$ 3.0 million (IQR: 2-5 million) in 2010. Conclusion: RSV-associated hospitalization among children aged < 5 years represents a substantial economic burden in Bangladesh. Affected families frequently incurred considerable out of pocket and indirect costs for treatment that resulted in financial hardship.",
    author = "Bhuiyan, {Mejbah Uddin} and Luby, {Stephen P.} and Alamgir, {Nadia Ishrat} and Nusrat Homaira and Katharine Sturm-Ramirez and Gurley, {Emily S.} and Jaynal Abedin and Zaman, {Rashid Uz} and Alamgir, {A. S.M.} and Mahmudur Rahman and Ortega-Sanchez, {Ismael R.} and Eduardo Azziz-Baumgartner",
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    journal = "Journal of Global Health",
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    publisher = "Edinburgh University Global Health Society",
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    Bhuiyan, MU, Luby, SP, Alamgir, NI, Homaira, N, Sturm-Ramirez, K, Gurley, ES, Abedin, J, Zaman, RU, Alamgir, ASM, Rahman, M, Ortega-Sanchez, IR & Azziz-Baumgartner, E 2017, 'Costs of hospitalization with respiratory syncytial virus illness among children aged < 5 years and the financial impact on households in Bangladesh, 2010' Journal of Global Health, vol. 7, no. 1, 010412. https://doi.org/10.7189/jogh.07.010412

    Costs of hospitalization with respiratory syncytial virus illness among children aged < 5 years and the financial impact on households in Bangladesh, 2010. / Bhuiyan, Mejbah Uddin; Luby, Stephen P.; Alamgir, Nadia Ishrat; Homaira, Nusrat; Sturm-Ramirez, Katharine; Gurley, Emily S.; Abedin, Jaynal; Zaman, Rashid Uz; Alamgir, A. S.M.; Rahman, Mahmudur; Ortega-Sanchez, Ismael R.; Azziz-Baumgartner, Eduardo.

    In: Journal of Global Health, Vol. 7, No. 1, 010412, 13.06.2017.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Costs of hospitalization with respiratory syncytial virus illness among children aged < 5 years and the financial impact on households in Bangladesh, 2010

    AU - Bhuiyan, Mejbah Uddin

    AU - Luby, Stephen P.

    AU - Alamgir, Nadia Ishrat

    AU - Homaira, Nusrat

    AU - Sturm-Ramirez, Katharine

    AU - Gurley, Emily S.

    AU - Abedin, Jaynal

    AU - Zaman, Rashid Uz

    AU - Alamgir, A. S.M.

    AU - Rahman, Mahmudur

    AU - Ortega-Sanchez, Ismael R.

    AU - Azziz-Baumgartner, Eduardo

    PY - 2017/6/13

    Y1 - 2017/6/13

    N2 - Background Respiratory syncytial virus (RSV) is the leading cause of acute respiratory illness in young children and results in significant economic burden. There is no vaccine to prevent RSV illness but a number of vaccines are in development. We conducted this study to estimate the costs of severe RSV illness requiring hospitalization among children <5 years and associated financial impact on households in Bangladesh. Data of this study could be useful for RSV vaccine development and also the value of various preventive strategies, including use of an RSV vaccine in children if one becomes available. Methods From May through October 2010, children aged < 5 years with laboratory-confirmed RSV were identified from a sentinel influenza program database at four tertiary hospitals. Research assistants visited case-patients' homes after hospital discharge and administered a structured questionnaire to record direct medical costs (physician consultation fee, costs for hospital bed, medicines and diagnostic tests); non-medical costs (costs for food, lodging and transportation); indirect costs (caregivers' productivity loss), and coping strategies used by families to pay for treatment. We used WHO-Choice estimates for routine health care service costs. We added direct, indirect and health care service costs to calculate cost-per-episode of severe RSV illness. We used Monte Carlo simulation to estimate annual economic burden for severe RSV illness. Findings We interviewed caregivers of 39 persons hospitalized for RSV illness. The median direct cost for hospitalization was US$ 62 (interquartile range [IQR] = 43-101), indirect cost was US$ 19 (IQR = 11-29) and total cost was US$ 94 (IQR = 67-127). The median out-of-pocket cost was 24% of monthly household income of affected families (US$ 143), and > 50% families borrowed money to meet treatment cost. We estimated that the median direct cost of RSV-associated hospitalization in children aged < 5 years in Bangladesh was US$ 10 million (IQR: US$ 7-16 million), the median indirect cost was US$ 3.0 million (IQR: 2-5 million) in 2010. Conclusion: RSV-associated hospitalization among children aged < 5 years represents a substantial economic burden in Bangladesh. Affected families frequently incurred considerable out of pocket and indirect costs for treatment that resulted in financial hardship.

    AB - Background Respiratory syncytial virus (RSV) is the leading cause of acute respiratory illness in young children and results in significant economic burden. There is no vaccine to prevent RSV illness but a number of vaccines are in development. We conducted this study to estimate the costs of severe RSV illness requiring hospitalization among children <5 years and associated financial impact on households in Bangladesh. Data of this study could be useful for RSV vaccine development and also the value of various preventive strategies, including use of an RSV vaccine in children if one becomes available. Methods From May through October 2010, children aged < 5 years with laboratory-confirmed RSV were identified from a sentinel influenza program database at four tertiary hospitals. Research assistants visited case-patients' homes after hospital discharge and administered a structured questionnaire to record direct medical costs (physician consultation fee, costs for hospital bed, medicines and diagnostic tests); non-medical costs (costs for food, lodging and transportation); indirect costs (caregivers' productivity loss), and coping strategies used by families to pay for treatment. We used WHO-Choice estimates for routine health care service costs. We added direct, indirect and health care service costs to calculate cost-per-episode of severe RSV illness. We used Monte Carlo simulation to estimate annual economic burden for severe RSV illness. Findings We interviewed caregivers of 39 persons hospitalized for RSV illness. The median direct cost for hospitalization was US$ 62 (interquartile range [IQR] = 43-101), indirect cost was US$ 19 (IQR = 11-29) and total cost was US$ 94 (IQR = 67-127). The median out-of-pocket cost was 24% of monthly household income of affected families (US$ 143), and > 50% families borrowed money to meet treatment cost. We estimated that the median direct cost of RSV-associated hospitalization in children aged < 5 years in Bangladesh was US$ 10 million (IQR: US$ 7-16 million), the median indirect cost was US$ 3.0 million (IQR: 2-5 million) in 2010. Conclusion: RSV-associated hospitalization among children aged < 5 years represents a substantial economic burden in Bangladesh. Affected families frequently incurred considerable out of pocket and indirect costs for treatment that resulted in financial hardship.

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    U2 - 10.7189/jogh.07.010412

    DO - 10.7189/jogh.07.010412

    M3 - Article

    VL - 7

    JO - Journal of Global Health

    JF - Journal of Global Health

    SN - 2047-2978

    IS - 1

    M1 - 010412

    ER -