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. 2025 Sep 17;20(9):e0317643.
doi: 10.1371/journal.pone.0317643. eCollection 2025.

Estimating the clinical and economic burden of medically attended influenza in South Korea, stratified by age and comorbidity: A five-season hospital-based surveillance data, 2014/15-2018/19

Min Joo Choi  1 , Won Suk Choi  2 , Joon Young Song  1   3 , Hee Jin Cheong  1   3 , Ji Yun Noh  1   3 , Seong-Heon Wie  4 , Jin Soo Lee  5 , Jacob Lee  6 , Hyo Youl Kim  7 , Shin-Woo Kim  8 , Kyong-Hwa Park  9 , Woo Joo Kim  1   3
Affiliations

Estimating the clinical and economic burden of medically attended influenza in South Korea, stratified by age and comorbidity: A five-season hospital-based surveillance data, 2014/15-2018/19

Min Joo Choi et al. PLoS One. .

Abstract

Objectives: This study aims to estimate the clinical and economic burden of influenza in South Korea across five seasons (2014/15-2018/19), stratified by age and comorbidity, using data from the Hospital-based Influenza Morbidity and Mortality (HIMM) network.

Methods: Data were gathered from eight university hospitals and included adults (≥ 20 years) with laboratory-confirmed influenza. The catchment population was estimated using hospital and national statistical data. Economic costs were evaluated from a societal perspective.

Results: The incidence of medically attended influenza ranged from 113.1 to 220.7 per 100,000 adults, with hospitalization rate of 35.5 to 76.8, intensive care unit admission at 4.2 to 9.2, and deaths at 1.4 to 3.6. Annual socioeconomic costs ranged from $156 to $316 million, primarily driven by indirect costs associated with early mortality. The highest cost was recorded in 2017/18, following the largest outbreak, particularly among older adults. Per capita socioeconomic costs ranged from $2,747 to $4,072 across the seasons, with peak values observed in 2018/19 and 2015/16. Among at-risk groups, per capita costs were 1.5-2.3 times higher than those of the general adult population.

Conclusions: Influenza imposes a significant clinical and economic burden on South Korea. Tailored strategies are essential to mitigate this burden, particularly among older adults and at-risk individuals not covered by the National Immunization Program.

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Conflict of interest statement

The authors received funding from Sanofi. The funder reviewed the manuscript prior to submission; however, they had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. This does not alter our adherence to PLOS ONE policies on sharing data and materials. The authors declare no other competing interests.

Figures

Fig 1
Fig 1. Estimated incidence per 100,000 persons of laboratory-confirmed influenza and related morbidity and mortality rates.
Fig 2
Fig 2. Severity of laboratory-confirmed influenza during five influenza seasons (2014/15–2018/19).
Fig 3
Fig 3. Analysis of per capita socioeconomic costs based on age and comorbidities.
See this image and copyright information in PMC

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