medigraphic.com
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán

2009, Number 1

<< Back Next >>

Rev Invest Clin 2009; 61 (1)

Resource utilization and costs of treating severe rotavirus diarrhea in young Mexican children from the health care provider perspective

Granados-García V, Velázquez-Castillo R, Garduño-Espinosa J, Torres-López J, Muñoz-Hernández O

Language: English
References: 30
Page: 18-25
PDF size: 142.96 Kb.


ABSTRACT

Background. Rotavirus is the most common cause of severe diarrhea in infants. The economic costs of treating severe rotavirus can be quite significant and are important to include in any evaluation of prevention programs. The aim of this study was to determine utilization of health care resources and costs incurred due to severe diarrhea associated with rotavirus infection in Mexican children ‹ 5 years of age. Material and methods. The costs of rotavirus infection evaluated in this observational study consisted of hospital, emergency room care and out-patient visit expenses at three hospitals of the Mexican Institute of Social Security throughout 1999-2000. Service costs were estimated from costs of care for rotavirus versus non-rotavirus diarrhea obtained through a follow-up study data of 383 children and administrative records. Results. Diarrhea cases due to rotavirus infection comprised 36% of the sample. Participants with rotavirus diarrhea spent an average of 3.2 days in the hospital, 5.9 hours in the emergency room, and had 1.3 visits to an outpatient physician’s office. Some differences in the consumption of health care were found between rotavirus and non-rotavirus diarrhea cases, although the mean costs of rotavirus and nonrotavirus cases were not significantly different. The mean cost per case of severe rotavirus diarrhea was estimated to be US$936. The total cost of treating severe rotavirus diarrhea, including 5,955 rotavirus hospitalizations for 2004, was estimated at US $5.5 million. Conclusion. Health care costs due to treatment for severe rotavirus diarrhea are a significant economic burden to the Mexican Social Security system.


REFERENCES

  1. Secretaria de Salud (SSA). Main causes of mortality in preschoolers age. National system of information in health (In Spanish). Mexico: 2004. Available at: http://sinais.salud.gob.mx/ mortalidad/mortalidad.htm (21 August 2007).

  2. Parashar UD, Hummerlman EG, Bresee JS, Miller MA, Glass RI. Global illness and deaths caused by rotavirus disease in children. Emerg Infect Dis 2003; 9: 565-72.

  3. Bresee JS, Glass RI, Parashar U, Gentsch Jon. Disease states and vaccines: selected cases. Part E. Rotavirus. In: Bloom BR and Lambert P (eds.). The Vaccine Book. CA, USA: Academic Press; 2003.

  4. Parashar UD, Alexander JP, Glass RI. Prevention of rotavirus gastroenteritis among infants and children. MMWR CDC. 2006; 55 (RR12).

  5. Glass RI, Parashar UD, Bresee JS Reina Turcios, Thea K Fischer, Marc-Alain Widdowson, et al. Rotavirus vaccines: current prospects and future challenges. Lancet 2006; 368: 323-32.

  6. Velázquez FR, García-Lozano H, Rodríguez E, Cervantes Y, Gomez A, Melo M, Anaya L, et al. Diarrhea morbidity and mortality in Mexican children. Impact of rotavirus disease. Pediatr Infect Dis J 2004; 23: S149-S155.

  7. Ehrenkranz P, Lanata CF, Penny ME,Salazar-Lindo E, Glass RI. Rotavirus diarrhea disease burden in Peru: the need for a rotavirus vaccine and its potential cost savings. Am J Public Health 2001; 10: 240-8.

  8. Tucker AW, Haddix AC, Breese JS, Holman RC, Parashar UD, Glass RI. Cost effectiveness analysis of a rotavirus immunization program for the United States. JAMA 1998; 279: 1371-6.

  9. Smith JC, Haddix AC, Teutsch SM, Glass RI. Cost-effectiveness analysis of a rotavirus immunization program for the United States. Pediatrics 1995; 96: 609-15.

  10. Griffiths RI, Anderson GF, Powe NR, Oliveras E, Herbert RJ, Grant CC, et al. Economic impact of immunization against rotavirus gastroenteritis: evidence from a clinical trial. Arch Pediatr Adolesc Med 1995; 149: 407-14.

  11. Liddle JL, Burgess MA, Gilbert GL, Hanson RM, McIntyre PB, Bishop RF, et al. Rotavirus gastroenteritis: impact on young children, their families and the health care system. Med J Aust 1997; 167: 304-7.

  12. Avendano P, Matson DO, Long J, Whitney S, Matson CC Pickering LK. Costs associated with office visits for diarrhea in infants and toddlers. Pediatr Infect Dis J 1993; 12: 897-902.

  13. Carlin JB, Jackson T, Lane L, Bishop RF, Barnes GL. Cost effectiveness of rotavirus vaccination in Australia. Aust N Z J Public Health 1999; 23: 611-16.

  14. Takala AK, Koskenniemi E, Joensuu J, Mäkelä M, Vesikari T. Economic evaluation of rotavirus vaccinations in Finland: randomized, double-blind, placebo controlled trial of tetravalent rhesus rotavirus vaccine. Clin Infect Dis 1998; 27(2): 272-82.

  15. Jacobs P, Shane LG, Fassbender K, Wang E, Moineddin R, Ford-Jones E. Economic analysis of rotavirus-associated diarrhea in the metropolitan Toronto and Peel regions of Ontario. Can J Infect Dis 2002; 13: 167-74.

  16. Podewils LJ, Antil L, Hummelman E, Bresee J, Parashar UD,1 Rheingans R. Projected cost-effectiveness of rotavirus vaccination for children in Asia. J Infect Dis 2005;192: S133-S145.

  17. Fisher TK, Anh DD, Cat NDL, et al. Health care cost of diarrheal disease and estimates of the cost-effectivenes of rotavirus vaccination in Vietnam. 2005. J Infect Dis 2005; 192: 1720-6.

  18. Delpiano L, Riquelme J, Casado C, et al. Clinical history and costs of gastroenteritis due to rotavirus in breastfeeding children: communitarian vs. nosocomial cases. [In Spanish] Rev Chil Infec 2006; 23: 35-42.

  19. Rheingans R, Constenla D, Antil L, et al. Economic and health burden of rotavirus gastroenteritis for the 2003 birth cohort in eight Latin American and Caribbean countries. Am J Public Health 2007; 21: 192-204.

  20. Velázquez FR, Castellanos A, Luna G, et al. Importance of viral agents as cause of severe diarrhea in children less than 5 years hospitalized and associated risk factors. In: García Peña C, Reyes Morales H, Viniegra Velázquez L (eds.). Strategic projects in health (In Spanish) México; 2001, p. 133-52.

  21. Ruuska T, Vesikary T. Rotavirus disease in Finnish Children: use of numerical scores for clinical severity of diarrheal episodes. Scand J Infect Dis 1990; 22: 259-67.

  22. Ruiz-Palacios GM, Pérez-Schael I, Velázquez FR, et al. Safety and efficacy of an attenuated vaccine against severe rotavirus gastroenteritis. N Engl J Med 2006; 354: 11-22.

  23. Secretaría de Salud. Guide for the effective management of children with acute diarrhea and patients with cholera. National Programme for the Control of Diarrheal Diseases. (In Spanish) Mexico City: 1992.

  24. Villareal-Rios E, Montalvo-Almaguer G, Salinas-Martinez AM, et al. Cost in the first level of atencion of IMSS. (In Spanish) Salud Publica Mex 1996; 38: 332-40.

  25. Direccion de Prestaciones Médicas. Instituto Mexicano del Seguro Social (IMSS). (In Spanish). Personal communication. Mexico: 2005.

  26. Barnum HJ, Kutzin J. Public Hospitals in Developing Countries. 1993. Baltimore, MD, USA: Johns Hopkins University Press; 1993.

  27. Flessa S. The cost of hospital services: a case study of Evangelical Lutheran Church hospitals in Tanzania. Health Policy and Plan 1998; 13(4): 397-407.

  28. Technical directorate of inforamation on health (DTIES). Instituto Mexicano del Seguro Social (IMSS). (In Spanish). Personal commication. Mexico: 2006.

  29. Arredondo A, Damian T, Icaza E. An approximation to the study of costs of health services in Mexico (In Spanish) Salud Pública Mex 1995; 37(5): 437-45.

  30. Bojalil R, Guiscafré H, Espinosa P, Viniegra L, Martínez H, Palafox M, Gutiérrez G. A clinical training unit for diarrhea and acute respiratory infections: an intervention for primary health care physicians in Mexico. Bull World Health Organ 1999; 77: 936-45.




2020     |     www.medigraphic.com