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[哥伦比亚波哥大成年人群中因肺炎链球菌引起的社区获得性肺炎、脑膜炎和菌血症需住院治疗的经济成本]

[Economic cost of Streptococcus pneumoniae community-acquired pneumonia, meningitis and bacteremia in an adult population that required hospitalization in Bogotá, Colombia].

作者信息

Calderón Claudia, Dennis Rodolfo

机构信息

Investigadora independiente, Bogotá, D.C, Colombia.

Departamento de Investigaciones, Fundación Cardioinfantil-Instituto de Cardiología, Bogotá, D.C, Colombia.

出版信息

Biomedica. 2014 Jan-Mar;34(1):92-101. doi: 10.1590/S0120-41572014000100012.

Abstract

INTRODUCTION

Streptococcus pneumoniae infection in adults is related to pneumonia, meningitis and bacteremia. Its care costs in adults are not well documented in Colombia and it has a greater impact in people over 45 years old.

OBJECTIVES

The aims of this study were to analyze the associated costs of pneumonia, bacteremia and meningitis in invasive S. pneumoniae infection in Colombia among hospitalized adults and to estimate outpatient costs for community-acquired pneumonia. Additionally, we wanted to serve as a starting point for future economic evaluations.

MATERIALS AND METHODS

We performed a direct cost study associated with S. pneumoniae outpatient community-acquired pneumonia, bacteremia and meningitis costs confirmed by cultures. A cohort of hospitalized adults treated between January 2010 and June 2011 in three third level hospitals in Bogotá was analyzed. We evaluated 107 records and 60 bills charged to the payer. The data were classified according to care and treatment costs. We performed an estimate of direct costs for community-acquired pneumonia for outpatient cases through Delphi methodology using expert clinicians.

RESULTS

The average direct costs associated with pneumococcal disease were US$ 6,283, US$ 3,886, and US$ 4,768 for pneumonia, meningitis and bacteremia, respectively (exchange rate 1 US$ = Col$ 1,938.34; average variation between 2010 and 2011). Pneumonia cases were 70% men and 30% women; the distribution for meningitis was the same for both genders (50%); and for bacteremia we had 67% men and 33% women. Outpatient cost of community-acquired pneumonia was estimated at US$ 82.2 ( Col $ 159,280 ) in adults. For special cases, direct cost increased to US$ 142 ( Col $ 274,427).

CONCLUSIONS

The management of S. pneumoniae infection in people over 45 years old represents a high cost due to the use of drugs and hospitalization, which has a direct impact on health resources. Prevention and early treatment for pneumonia can reduce the cost and the burden of the disease.

摘要

引言

成人肺炎链球菌感染与肺炎、脑膜炎和菌血症有关。在哥伦比亚,其在成人中的护理成本尚无充分记录,且对45岁以上人群影响更大。

目的

本研究旨在分析哥伦比亚住院成人侵袭性肺炎链球菌感染中肺炎、菌血症和脑膜炎的相关成本,并估算社区获得性肺炎的门诊成本。此外,我们希望作为未来经济评估的起点。

材料与方法

我们进行了一项与肺炎链球菌门诊社区获得性肺炎、菌血症和脑膜炎成本相关的直接成本研究,这些成本通过培养确诊。分析了2010年1月至2011年6月在波哥大三家三级医院接受治疗的住院成人队列。我们评估了107份记录和向付款人收取的60张账单。数据根据护理和治疗成本进行分类。我们通过德尔菲法,利用临床专家对门诊社区获得性肺炎的直接成本进行了估算。

结果

肺炎、脑膜炎和菌血症的肺炎球菌疾病平均直接成本分别为6283美元、3886美元和4768美元(汇率1美元=1938.34哥伦比亚比索;2010年至2011年平均变化)。肺炎病例中男性占70%,女性占30%;脑膜炎的男女分布相同(各占50%);菌血症病例中男性占67%,女性占33%。成人社区获得性肺炎的门诊成本估计为82.2美元(159280哥伦比亚比索)。对于特殊情况,直接成本增至142美元(274427哥伦比亚比索)。

结论

由于药物使用和住院治疗,45岁以上人群肺炎链球菌感染的管理成本高昂,这对卫生资源有直接影响。肺炎的预防和早期治疗可降低成本和疾病负担。

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