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. 2013 Aug 5:72.
doi: 10.3402/ijch.v72i0.21595. eCollection 2013.

The cost of lower respiratory tract infections hospital admissions in the Canadian Arctic

Anna Banerji  1 , Val Panzov, Joan Robinson, Michael Young, Kaspar Ng, Muhammad Mamdani
Affiliations

The cost of lower respiratory tract infections hospital admissions in the Canadian Arctic

Anna Banerji et al. Int J Circumpolar Health. .

Abstract

Background: Inuit infants who reside in the Nunavut (NU) regions of Arctic Canada have extremely high rates of lower respiratory tract infections (LRTIs) associated with significant health expenditures, but the costs in other regions of Arctic Canada have not been documented.

Objective: This prospective surveillance compares, across most of Arctic Canada, the rates and costs associated with LRTI admissions in infants less than 1 year of age, and the days of hospitalization and costs adjusted per live birth.

Design: This was a hospital-based surveillance of LRTI admissions of infants less than 1 year of age, residing in Northwest Territories (NT), the 3 regions of Nunavut (NU); [Kitikmeot (KT), Kivalliq (KQ) and Qikiqtani (QI)] and Nunavik (NK) from 1 January 2009 to 30 June 2010. Costs were obtained from the territorial or regional governments and hospitals, and included transportation, hospital stay, physician fees and accommodation costs. The rates of LRTI hospitalizations, days of hospitalization and associated costs were calculated per live birth in each of the 5 regions.

Results: There were 513 LRTI admissions during the study period. For NT, KT, KQ, QI and NK, the rates of LRTI hospitalization per 1000 live births were 38, 389, 230, 202 and 445, respectively. The total days of LRTI admission per live birth were 0.25, 3.3, 2.6, 1.7 and 3 for the above regions. The average cost per live birth for LRTI admission for these regions was $1,412, $22,375, $14,608, $8,254 and $10,333. The total cost for LRTI was $1,498,232 in NT, $15,662,968 in NU and $3,874,881 in NK. Medical transportation contributed to a significant proportion of the costs.

Conclusion: LRTI admission rates in NU and Nunavik are much higher than that in NT and remain among the highest rates globally. The costs of these admissions are exceptionally high due to the combination of very high rates of admission, very expensive medical evacuations and prolonged hospitalizations. Decreasing the rates of LRTI in this population could result in substantial health savings.

Keywords: Canadian Arctic; Inuit; Lower Respiratory tract infections (or LRTI); costs.

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Figures

Fig. 1
Fig. 1
Map of Inuit regions in Canada and typical referral patterns in 2009.
See this image and copyright information in PMC

References

    1. Banerji A, Greenberg D, White LF, Macdonald WA, Saxton A, Thomas E, et al. Risk factors and viruses associated with hospitalization due to lower respiratory tract infections in Canadian Inuit children: a case-control study. Pediatr Infect Dis J. 2009;28:697–701. - PubMed
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    1. Carson JB, Postl BD, Spady D, Schaefer O. Lower respiratory tract infections among Canadian Inuit Children. Int J Circumpolar Health. 1984;84:226–8.

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