[Health economic impact of viral respiratory infections and pneumonia diseases on the elderly population in Poland]

Abstract

Respiratory diseases and particularly those linked to pneumonia and influenza infections are a leading cause of serious illness. Streptococcus pneumoniae is responsible for 30 to 50% of all community-acquired pneumonia. It is also a common bacterial complication of influenza, especially in the frail populations, such as the elderly. There are scarce data reporting the medical and economic burden of these infections in Poland. Polish authorities recommend influenza and pneumococcal vaccinations for subjects aged 65 years and over but there is not public vaccination program in place for covering immunization. Elderly vaccination rates against influenza and pneumonia in Poland remain far below the World Health Organization's recommendations. THE AIMS OF THE STUDY: To assess the mean economic costs of influenza and pneumococcal diseases in the Polish elderly population, treated in outpatient and inpatient settings. Costs were estimated from the public payer and societal perspectives.

Material and methods: Data were collected retrospectively from 2007 to 2009 in three different sites: a general practitioner Family clinic for outpatient data and two hospitals in Warsaw for inpatient data. Resource use linked to pneumonia orinfluenza treatments were collected from each site. Microcosting calculation method was used to estimate the outpatient costs. Inpatient costs were measured using the Ministry of Health patient's payment for each diagnosis group (DRG) but also using each subject's treatment inpatient costs added to the cost of hospital stay.

Results: Mean outpatient cost for treating an outpatient was 101 PLN for influenza (1 euro = 4 PLN) and 186 PLN for community-acquired pneumonia. Mean total hospitalization cost including treatment cost and cost of stay was 7633 PLN among P&I patients whereas the DRG cost for this diagnosis was 1885 PLN. Similarly, the mean total inpatient cost was estimated to be 7162 PLN for Streptococcal bacteremia (DRG payment: 7140 PLN) and 4104 PLN for meningitis (DRG payment: 3804 PLN).

Conclusions: This study highlights the significant economic impact of influenza and pneumococcal diseases in the Polish population aged 65 years and over. Complications of influenza and pneumonia diseases contribute to weight down this burden as they often lead to hospitalizations in these frail populations. This first economic assessment is a 1st step in the measurement of the value of preventing these diseases through vaccination.