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. 2020 Jun;67(4):407-415.
doi: 10.1111/zph.12699.

Epidemiology and cost of Lyme disease-related hospitalizations among patients with employer-sponsored health insurance-United States, 2005-2014

Amy M Schwartz  1 , Manjunath B Shankar  2 , Kiersten J Kugeler  1 , Ryan J Max  1 , Alison F Hinckley  1 , Martin I Meltzer  2 , Christina A Nelson  1
Affiliations

Epidemiology and cost of Lyme disease-related hospitalizations among patients with employer-sponsored health insurance-United States, 2005-2014

Amy M Schwartz et al. Zoonoses Public Health. 2020 Jun.

Abstract

An estimated 300,000 cases of Lyme disease occur in the United States annually. Disseminated Lyme disease may result in carditis, arthritis, facial palsy or meningitis, sometimes requiring hospitalization. We describe the epidemiology and cost of Lyme disease-related hospitalizations. We analysed 2005-2014 data from the Truven Health Analytics MarketScan Commercial Claims and Encounters Databases to identify inpatient records associated with Lyme disease based on International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. We estimated the annual number and median cost of Lyme disease-related hospitalizations in the United States in persons under 65 years of age. Costs were adjusted to reflect 2016 dollars. Of 20,983,165 admission records contained in the inpatient databases during the study period, 2,823 (0.01%) met inclusion criteria for Lyme disease-related hospitalizations. Over half of the identified records contained an ICD-9-CM code for meningitis (n = 614), carditis (n = 429), facial palsy (n = 400) or arthritis (n = 377). Nearly 60% of hospitalized patients were male. The median cost per Lyme disease-related hospitalization was $11,688 (range: $140-$323,613). The manifestation with the highest median cost per stay was carditis ($17,461), followed by meningitis ($15,177), arthritis ($13,012) and facial palsy ($10,491). Median cost was highest among the 15- to 19-year-old age group ($12,991). Admissions occurring in January had the highest median cost ($13,777) for all study years. Based on extrapolation to the U.S. population, we estimate that 2,196 Lyme disease-related hospitalizations in persons under 65 years of age occur annually with an estimated annual cost of $25,826,237. Lyme disease is usually treated in an outpatient setting; however, some patients with Lyme disease require hospitalization, underscoring the need for effective prevention methods to mitigate these serious cases. Information from this analysis can aid economic evaluations of interventions that prevent infection and advances in disease detection.

Keywords: Lyme disease; claims analysis; cost of illness; tick borne diseases.

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Conflict of interest statement

CONFLICT OF INTEREST

The authors have no conflict of interest to declare. The views expressed in this article are those of the authors and do not necessarily represent the official position of the U.S. Centers for Disease Control and Prevention.

Figures

FIGURE 1
FIGURE 1
Study population and number of patients with Lyme disease-related hospitalizations and manifestations. *Two individual patients had two separate hospitalization stays where the principal diagnosis code was Lyme disease on 1 stay and a manifestation on the other stay. †1,240 hospitalizations did not have a diagnosis code for a pre-specified manifestation
FIGURE 2
FIGURE 2
Proportion of Lyme disease-related hospitalizations by age group and manifestation—United States, 2005–2014
FIGURE 3
FIGURE 3
Number, mean and median cost of Lyme disease-related hospitalizations by month of admission—United States, 2005–2014
FIGURE 4
FIGURE 4
Proportion of manifestation in patients hospitalized for Lyme disease, by month—United States, 2005–2014
FIGURE 5
FIGURE 5
Cost of Lyme disease-related hospitalizations by manifestation—United States, 2005–2014
See this image and copyright information in PMC

References

    1. Adrion ER, Aucott J, Lemke KW, & Weiner JP (2015). Health care costs, utilization and patterns of care following Lyme disease. PLoS ONE, 10, e0116767 10.1371/journal.pone.0116767 - DOI - PMC - PubMed
    1. Bleyenheuft C, Lernout T, Berger N, Rebolledo J, Leroy M, Robert A, & Quoilin S (2015). Epidemiological situation of Lyme borreliosis in Belgium, 2003 to 2012. Archives of Public Health, 73, 33 10.1186/s13690-015-0079-7 - DOI - PMC - PubMed
    1. Board of Governors of the Federal Reserve System (2020). Foreign exchange rates - H.10. Retrieved from: https://www.federalreserve.gov/releases/h10/default.htm
    1. Gould LH, Nelson RS, Griffith KS, Hayes EB, Piesman J, Mead PS, & Cartter ML (2008). Knowledge, attitudes, and behaviors regarding Lyme disease prevention among Connecticut residents, 1999–2004. Vector-Borne and Zoonotic Diseases, 8, 769–776. 10.1089/vbz.2007.0221 - DOI - PubMed
    1. Hansen L (2017). The Truven Health MarketScan Databases for life sciences researchers. Retrieved from https://truvenhealth.com/Portals/0/Assets/2017-MarketScan-Databases-Life...