Hospital and economic burden of influenza-like illness and lower respiratory tract infection in adults ≥50 years-old

Cecilia Trucchi, Chiara Paganino, Andrea Orsi, Daniela Amicizia, Valentino Tisa, Maria Francesca Piazza, Domenico Gallo, Simona Simonetti, Bruno Buonopane, Giancarlo Icardi, Filippo Ansaldi

Research output: Contribution to journalArticle

Abstract

Background: Influenza-like illnesses (ILIs) and lower respiratory tract infections (LRTIs) cause substantial morbidity and mortality worldwide. The study assessed the health and economic burden of ILI and LRTI according to age and comorbidities, since available evidence is limited and heterogeneous. Method: The prevalence of comorbidities, the seasonal incidence rates and the mean and per capita direct costs of ED accesses for ILI/LRTI, whether followed by hospitalization or not, recorded in adults aged ≥50 years over the last 6 years, in the referral hospitals located in the Genoese metropolitan area (Liguria, Italy) where the syndromic surveillance system is active, were evaluated through a retrospective observational study. Comorbidities were estimated through the Chronic Condition Data Warehouse that integrates multiple Medicare data sources. A comparison with the administrative healthcare International Classification of Diseases-9th revision-Clinical Modification (ICD-9-CM)-based data was also conducted. Results: The prevalence of subjects with ≥1 comorbidity ranged from 23.49 to 59.92%. The most prevalent all-age comorbidities were cardiovascular diseases and cancer. The overall ILI/LRTI incidence rate was 6.73/1000 person-years, almost double the value derived from routine data, and increased with age. The highest rates were observed in patients with renal failure and bronchopneumopathies. The mean cost of ED accesses/hospitalization for ILI/LRTI was €3353 and was almost twice as high in the ≥85 years as in the youngest age-group. The highest mean costs were observed in patients with renal failure and cancer. The per capita costs increased from €4 to €71 with age, and were highest in patients with renal failure and bronchopneumopathy. Conclusion: The burden of ILIs/LRTIs in terms of ED accesses and hospitalizations in adults aged ≥50 years is heavy, and is related to increasing age and, especially, to specific comorbidities. These results could contribute to revising age- and risk-based anti-influenza and -pneumococcus immunization strategies.

Original languageEnglish
Article number585
JournalBMC Health Services Research
Volume19
Issue number1
DOIs
Publication statusPublished - Aug 19 2019

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Hospital Economics
Respiratory Tract Infections
Human Influenza
Comorbidity
Renal Insufficiency
Costs and Cost Analysis
Hospitalization
Kidney Neoplasms
Information Storage and Retrieval
Incidence
International Classification of Diseases
Medicare
Streptococcus pneumoniae
Italy
Observational Studies
Immunization
Cardiovascular Diseases
Referral and Consultation
Retrospective Studies
Age Groups

Keywords

  • Anti-influenza and pneumococcus immunization strategies
  • Chronic condition data warehouse
  • Comorbidities
  • Influenza-like illness
  • Lower respiratory tract infection
  • Syndromic surveillance system

ASJC Scopus subject areas

  • Health Policy

Cite this

Hospital and economic burden of influenza-like illness and lower respiratory tract infection in adults ≥50 years-old. / Trucchi, Cecilia; Paganino, Chiara; Orsi, Andrea; Amicizia, Daniela; Tisa, Valentino; Piazza, Maria Francesca; Gallo, Domenico; Simonetti, Simona; Buonopane, Bruno; Icardi, Giancarlo; Ansaldi, Filippo.

In: BMC Health Services Research, Vol. 19, No. 1, 585, 19.08.2019.

Research output: Contribution to journalArticle

Trucchi, C, Paganino, C, Orsi, A, Amicizia, D, Tisa, V, Piazza, MF, Gallo, D, Simonetti, S, Buonopane, B, Icardi, G & Ansaldi, F 2019, 'Hospital and economic burden of influenza-like illness and lower respiratory tract infection in adults ≥50 years-old', BMC Health Services Research, vol. 19, no. 1, 585. https://doi.org/10.1186/s12913-019-4412-7
Trucchi, Cecilia ; Paganino, Chiara ; Orsi, Andrea ; Amicizia, Daniela ; Tisa, Valentino ; Piazza, Maria Francesca ; Gallo, Domenico ; Simonetti, Simona ; Buonopane, Bruno ; Icardi, Giancarlo ; Ansaldi, Filippo. / Hospital and economic burden of influenza-like illness and lower respiratory tract infection in adults ≥50 years-old. In: BMC Health Services Research. 2019 ; Vol. 19, No. 1.
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AU - Orsi, Andrea

AU - Amicizia, Daniela

AU - Tisa, Valentino

AU - Piazza, Maria Francesca

AU - Gallo, Domenico

AU - Simonetti, Simona

AU - Buonopane, Bruno

AU - Icardi, Giancarlo

AU - Ansaldi, Filippo

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N2 - Background: Influenza-like illnesses (ILIs) and lower respiratory tract infections (LRTIs) cause substantial morbidity and mortality worldwide. The study assessed the health and economic burden of ILI and LRTI according to age and comorbidities, since available evidence is limited and heterogeneous. Method: The prevalence of comorbidities, the seasonal incidence rates and the mean and per capita direct costs of ED accesses for ILI/LRTI, whether followed by hospitalization or not, recorded in adults aged ≥50 years over the last 6 years, in the referral hospitals located in the Genoese metropolitan area (Liguria, Italy) where the syndromic surveillance system is active, were evaluated through a retrospective observational study. Comorbidities were estimated through the Chronic Condition Data Warehouse that integrates multiple Medicare data sources. A comparison with the administrative healthcare International Classification of Diseases-9th revision-Clinical Modification (ICD-9-CM)-based data was also conducted. Results: The prevalence of subjects with ≥1 comorbidity ranged from 23.49 to 59.92%. The most prevalent all-age comorbidities were cardiovascular diseases and cancer. The overall ILI/LRTI incidence rate was 6.73/1000 person-years, almost double the value derived from routine data, and increased with age. The highest rates were observed in patients with renal failure and bronchopneumopathies. The mean cost of ED accesses/hospitalization for ILI/LRTI was €3353 and was almost twice as high in the ≥85 years as in the youngest age-group. The highest mean costs were observed in patients with renal failure and cancer. The per capita costs increased from €4 to €71 with age, and were highest in patients with renal failure and bronchopneumopathy. Conclusion: The burden of ILIs/LRTIs in terms of ED accesses and hospitalizations in adults aged ≥50 years is heavy, and is related to increasing age and, especially, to specific comorbidities. These results could contribute to revising age- and risk-based anti-influenza and -pneumococcus immunization strategies.

AB - Background: Influenza-like illnesses (ILIs) and lower respiratory tract infections (LRTIs) cause substantial morbidity and mortality worldwide. The study assessed the health and economic burden of ILI and LRTI according to age and comorbidities, since available evidence is limited and heterogeneous. Method: The prevalence of comorbidities, the seasonal incidence rates and the mean and per capita direct costs of ED accesses for ILI/LRTI, whether followed by hospitalization or not, recorded in adults aged ≥50 years over the last 6 years, in the referral hospitals located in the Genoese metropolitan area (Liguria, Italy) where the syndromic surveillance system is active, were evaluated through a retrospective observational study. Comorbidities were estimated through the Chronic Condition Data Warehouse that integrates multiple Medicare data sources. A comparison with the administrative healthcare International Classification of Diseases-9th revision-Clinical Modification (ICD-9-CM)-based data was also conducted. Results: The prevalence of subjects with ≥1 comorbidity ranged from 23.49 to 59.92%. The most prevalent all-age comorbidities were cardiovascular diseases and cancer. The overall ILI/LRTI incidence rate was 6.73/1000 person-years, almost double the value derived from routine data, and increased with age. The highest rates were observed in patients with renal failure and bronchopneumopathies. The mean cost of ED accesses/hospitalization for ILI/LRTI was €3353 and was almost twice as high in the ≥85 years as in the youngest age-group. The highest mean costs were observed in patients with renal failure and cancer. The per capita costs increased from €4 to €71 with age, and were highest in patients with renal failure and bronchopneumopathy. Conclusion: The burden of ILIs/LRTIs in terms of ED accesses and hospitalizations in adults aged ≥50 years is heavy, and is related to increasing age and, especially, to specific comorbidities. These results could contribute to revising age- and risk-based anti-influenza and -pneumococcus immunization strategies.

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KW - Chronic condition data warehouse

KW - Comorbidities

KW - Influenza-like illness

KW - Lower respiratory tract infection

KW - Syndromic surveillance system

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