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BOCCALINI SARA, PANATTO DONATELLA, MENNINI FRANCESCOSAVERIO, MARCELLUSI ANDREA, BINI CHIARA, AMICIZIA DANIELA, LAI PIEROLUIGI, MICALE ROSANNATINDARA, FRUMENTO DAVIDE, AZZARI CHIARA, RICCI SILVIA, BONITO BENEDETTA, DI PISA GIULIA, IOVINE MARIASILVIA, LODI LORENZO, GIOVANNINI MATTIA, MOSCADELLI ANDREA, PAOLI SONIA, PENNATI BEATRICEMARINA, PISANO LAURA, BECHINI ANGELA, BONANNI PAOLO. [ Health Technology Assessment (HTA) of the introduction of additional cohorts for anti-meningococcal vaccination with quadrivalent conjugate vaccines in Italy]. JOURNAL OF PREVENTIVE MEDICINE AND HYGIENE 2021; 62:E1-E128. [PMID: 34622076 PMCID: PMC8452280 DOI: 10.15167/2421-4248/jpmh2021.62.1s1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- SARA BOCCALINI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
- Autore corrispondente: Sara Boccalini, Dipartimento di Scienze della Salute, Università degli Studi di Firenze, 50134 Firenze, Italia - Tel.: 055-2751084 E-mail:
| | - DONATELLA PANATTO
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - FRANCESCO SAVERIO MENNINI
- Economic Evaluation and HTA - CEIS (EEHTA - CEIS), Facoltà di Economia, Università di Roma "Tor Vergata"
- Institute for Leadership and Management in Health, Kingston University, London, UK
| | - ANDREA MARCELLUSI
- Economic Evaluation and HTA - CEIS (EEHTA - CEIS), Facoltà di Economia, Università di Roma "Tor Vergata"
| | - CHIARA BINI
- Economic Evaluation and HTA - CEIS (EEHTA - CEIS), Facoltà di Economia, Università di Roma "Tor Vergata"
| | - DANIELA AMICIZIA
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - PIERO LUIGI LAI
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | | | - DAVIDE FRUMENTO
- Dipartimento di Scienze della Salute, Università degli Studi di Genova
| | - CHIARA AZZARI
- Immunologia, Clinica Pediatrica II, AOU Meyer, Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - SILVIA RICCI
- Immunologia, Clinica Pediatrica II, AOU Meyer, Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - BENEDETTA BONITO
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - GIULIA DI PISA
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | | | - LORENZO LODI
- Immunologia, Clinica Pediatrica II, AOU Meyer, Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - MATTIA GIOVANNINI
- Immunologia, Clinica Pediatrica II, AOU Meyer, Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - ANDREA MOSCADELLI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - SONIA PAOLI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | | | - LAURA PISANO
- Immunologia, Clinica Pediatrica II, AOU Meyer, Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - ANGELA BECHINI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
| | - PAOLO BONANNI
- Dipartimento di Scienze della Salute, Università degli Studi di Firenze
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Adil SM, Hodges SE, Charalambous LT, Kiyani M, Liu B, Lee HJ, Parente BA, Perfect JR, Lad SP. Paediatric bacterial meningitis in the USA: outcomes and healthcare resource utilization of nosocomial versus community-acquired infection. J Med Microbiol 2020; 70. [PMID: 33206032 DOI: 10.1099/jmm.0.001276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Introduction. Paediatric bacterial meningitis remains a costly disease, both financially and clinically.Hypothesis/Gap Statement. Previous epidemiological and cost studies of bacterial meningitis (BM) have largely focused on adult populations or single pathogens. There have been few recent, large-scale studies of pediatric BM in the USA.Aim. We examined healthcare resource utilization (HCRU) and associated morbidity and mortality of community-acquired versus nosocomial bacterial infections in children across the USA.Methodology. The IBM MarketScan Research databases were used to identify patients <18 years old admitted to USA hospitals from 2008 to 2015 with a primary diagnosis of BM. Cases were categorized as either community-acquired or nosocomial. HCRU, post-diagnosis neurosurgical procedures, 30-day in-hospital mortality, and complications were compared between groups. Multivariable regression adjusted for sex, age and Gram staining was used to compare costs of nosocomial versus community-acquired infections over time.Results. We identified 1928 cases of paediatric BM without prior head trauma or neurological/systemic complications. Of these, 15.4 % were nosocomial and 84.6 % were community-acquired infections. After diagnostic lumbar puncture (37.1 %), the most common neurosurgical procedure was placement of ventricular catheter (12.6 %). The 30-day complication rates for nosocomial and community-acquired infections were 40.5 and 45.9 %, respectively. The most common complications were hydrocephalus (20.8 %), intracranial abscess (8.8 %) and cerebral oedema (8.1 %). The 30-day in-hospital mortality rates for nosocomial and community-acquired infections were 2.7 and 2.8 %, respectively.Median length of admission was 14.0 days (Q1: 7 days, Q3: 26 days). Median 90-day cost was $40 861 (Q1: $11 988, Q3: $114,499) for the nosocomial group and $56 569 (Q1: $26 127, Q3: $142 780) for the community-acquired group. In multivariable regression, the 90-day post-diagnosis total costs were comparable between groups (cost ratio: 0.89; 95 % CI: 0.70 to 1.13), but at 2 years post-diagnosis, the nosocomial group was associated with 137 % higher costs (CR: 2.37, 95 % CI: 1.51 to 3.70).Conclusion. In multivariable analysis, nosocomial infections were associated with significantly higher long-term costs up to 2 years post-infection. Hydrocephalus, intracranial epidural abscess and cerebral oedema were the most common complications, and lumbar punctures and ventricular catheter placement were the most common neurosurgical procedures. This study represents the first nation-wide, longitudinal comparison of the outcomes and considerable HCRU of nosocomial versus community-acquired paediatric BM, including characterization of complications and procedures contributing to the high costs of these infections.
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Affiliation(s)
- Syed M Adil
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - Sarah E Hodges
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | | | - Musa Kiyani
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - Beiyu Liu
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA
| | - Hui-Jie Lee
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC, USA
| | - Beth A Parente
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
| | - John R Perfect
- Division of Infectious Diseases, Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Shivanand P Lad
- Department of Neurosurgery, Duke University Medical Center, Durham, NC, USA
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Bilyk I, Fedyak I, Ivaniulyk II, Havryshchuk L. Clinical and economic estimation of children’s pharmacotherapy with meningococcial infections in Ukraine. PHARMACIA 2019. [DOI: 10.3897/pharmacia.66.e35186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A comprehensive study for assessment the appointments rationality for children with meningococcal infectious (MI) in Ukraine in real clinical practice has been conducted. The doctor’s appointment sheets from 184 inpatients medical cards have been processed by the integral ABC / VEN / frequency analysis. In average, children were in the hospital (14±7) bed-days, they were granted 2908 appointments of 191 drugs by the INN. It has been established that medicine for MI etiotropic therapy took the third place in the appointments frequency. At the same time, the ABC / VEN-analysis results revealed a rational approach to pharmacotherapy.The total treatment cost was estimated at USD 25,173.59 (for one child – USD 136.81).Since currently in Ukraine inpatient children treatment is mainly provided by parents, further medical prescriptions improvement is needed in order to increase the efficiency and minimize the childrenMI therapy cost.
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