Resource utilization and cost of influenza requiring hospitalization in Canadian adults: A study from the serious outcomes surveillance network of the Canadian Immunization Research Network Academic Article uri icon

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abstract

  • BACKGROUND: Consideration of cost determinants is crucial to inform delivery of public vaccination programs. OBJECTIVES: To estimate the average total cost of laboratory-confirmed influenza requiring hospitalization in Canadians prior to, during, and 30 days following discharge. To analyze effects of patient/disease characteristics, treatment, and regional differences in costs. METHODS: Study utilized previously recorded clinical characteristics, resource use, and outcomes of laboratory-confirmed influenza patients admitted to hospitals in the Serious Outcomes Surveillance (SOS), Canadian Immunization Research Network (CIRN), from 2010/11 to 2012/13. Unit costs including hospital overheads were linked to inpatient/outpatient resource utilization before and after admissions. RESULTS: Dataset included 2943 adult admissions to 17 SOS Network hospitals and 24 Toronto Invasive Bacterial Disease Network hospitals. Mean age was 69.5 years. Average hospital stay was 10.8 days (95% CI: 10.3, 11.3), general ward stays were 9.4 days (95% CI: 9.0, 9.8), and ICU stays were 9.8 days (95% CI: 8.6, 11.1) for the 14% of patients admitted to the ICU. Average cost per case was $14 612 CAD (95% CI: $13 852, $15 372) including $133 (95% CI: $116, $150) for medical care prior to admission, $14 031 (95% CI: $13 295, $14 768) during initial hospital stay, $447 (95% CI: $271, $624) post-discharge, including readmission within 30 days. CONCLUSION: The cost of laboratory-confirmed influenza was higher than previous estimates, driven mostly by length of stay and analyzing only laboratory-confirmed influenza cases. The true per-patient cost of influenza-related hospitalization has been underestimated, and prevention programs should be evaluated in this context.

authors

  • Ng, Carita
  • Ye, Lingyun
  • Noorduyn, Stephen G
  • Hux, Margaret
  • Thommes, Edward
  • Goeree, Ron
  • Ambrose, Ardith
  • Andrew, Melissa K
  • Hatchette, Todd
  • Boivin, Guy
  • Bowie, William
  • ElSherif, May
  • Green, Karen
  • Johnstone, Jennie
  • Katz, Kevin
  • Leblanc, Jason
  • Loeb, Mark
  • MacKinnon-Cameron, Donna
  • McCarthy, Anne
  • McElhaney, Janet
  • McGeer, Allison
  • Poirier, Andre
  • Powis, Jeff
  • Richardson, David
  • Sharma, Rohita
  • Semret, Makeda
  • Smith, Stephanie
  • Smyth, Daniel
  • Stiver, Grant
  • Trottier, Sylvie
  • Valiquette, Louis
  • Webster, Duncan
  • McNeil, Shelly A

publication date

  • March 2018