Varicella healthcare resource utilization in middle income countries: a pooled analysis of the multi-country MARVEL study in Latin America & Europe
Varicella is a mild and self-limited illness in children, but can result in significant healthcare resource utilization (HCRU). To quantify/contrast varicella-associated HCRU in five middle-income countries (Hungary, Poland, Argentina, Mexico, and Peru) where universal varicella vaccination was unim...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2019-04-01
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| Series: | Human Vaccines & Immunotherapeutics |
| Subjects: | |
| Online Access: | http://dx.doi.org/10.1080/21645515.2018.1559687 |
| _version_ | 1827809725492756480 |
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| author | Lara J. Wolfson Maria Esther Castillo Norberto Giglio Zsofia Meszner Zsuzsanna Molnar Mirella Vazquez Jacek Wysocki Alexandra Altland Barbara J. Kuter Jenaya Rickard Emmanouil Rampakakis |
| author_facet | Lara J. Wolfson Maria Esther Castillo Norberto Giglio Zsofia Meszner Zsuzsanna Molnar Mirella Vazquez Jacek Wysocki Alexandra Altland Barbara J. Kuter Jenaya Rickard Emmanouil Rampakakis |
| author_sort | Lara J. Wolfson |
| collection | DOAJ |
| description | Varicella is a mild and self-limited illness in children, but can result in significant healthcare resource utilization (HCRU). To quantify/contrast varicella-associated HCRU in five middle-income countries (Hungary, Poland, Argentina, Mexico, and Peru) where universal varicella vaccination was unimplemented, charts were retrospectively reviewed among 1–14 year-olds. Data were obtained on management of primary varicella between 2009–2016, including outpatient/inpatient visits, allied healthcare contacts, tests/procedures, and medications. These results are contrasted across countries, and a regression model is fit to extrapolated country-level costs as a function of gross domestic product (GDP). A total of 401 outpatients and 386 inpatients were included. Significant differences between countries were observed in the number of skin lesions among outpatients, ranging from 5.3% to 25.4% of patients with ≥250 lesions. Among inpatients, results were less variable. Average ambulatory medical visits ranged from 1.1 to 2.2. Average hospital stay ranged from 3.6 to 6.8 days. Use of tests/procedures was infrequent in outpatients, except in Argentina (13.3%); among inpatients, a test/procedure was ordered for 81.3% of patients, without regional variation. Prescription medications were administered in 44.4% of outpatients (range 9.3%–80.0%), and in 86% of inpatients (range 70.4%–94.9%). Total estimated spending on varicella treatment in the absence of vaccination was predicted from income levels (GDP) with an exponential function (R2 = 0.89). This study demonstrates that substantial HCRU is associated with varicella resulting in significant public health burden that could be alleviated through the use of varicella vaccination. Differences observed between countries possibly reflect treatment guidelines, healthcare resource availabilities and physician practices. |
| first_indexed | 2024-03-11T22:44:57Z |
| format | Article |
| id | doaj.art-82b2e376f742422f8b4dac0c583a42fc |
| institution | Directory Open Access Journal |
| issn | 2164-5515 2164-554X |
| language | English |
| last_indexed | 2024-03-11T22:44:57Z |
| publishDate | 2019-04-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Human Vaccines & Immunotherapeutics |
| spelling | doaj.art-82b2e376f742422f8b4dac0c583a42fc2023-09-22T08:38:25ZengTaylor & Francis GroupHuman Vaccines & Immunotherapeutics2164-55152164-554X2019-04-0115493294110.1080/21645515.2018.15596871559687Varicella healthcare resource utilization in middle income countries: a pooled analysis of the multi-country MARVEL study in Latin America & EuropeLara J. Wolfson0Maria Esther Castillo1Norberto Giglio2Zsofia Meszner3Zsuzsanna Molnar4Mirella Vazquez5Jacek Wysocki6Alexandra Altland7Barbara J. Kuter8Jenaya Rickard9Emmanouil Rampakakis10Merck & Co., IncInstituto Nacional de Salud del Niño (INSN)Hospital de Niños Ricardo GutiérrezSt. László Hospital for Infectious DiseasesNational Center for EpidemiologyInstituto Nacional de PediatríaPoznan University of Medical SciencesMerck & Co., IncMerck & Co., IncJSS Medical ResearchJSS Medical ResearchVaricella is a mild and self-limited illness in children, but can result in significant healthcare resource utilization (HCRU). To quantify/contrast varicella-associated HCRU in five middle-income countries (Hungary, Poland, Argentina, Mexico, and Peru) where universal varicella vaccination was unimplemented, charts were retrospectively reviewed among 1–14 year-olds. Data were obtained on management of primary varicella between 2009–2016, including outpatient/inpatient visits, allied healthcare contacts, tests/procedures, and medications. These results are contrasted across countries, and a regression model is fit to extrapolated country-level costs as a function of gross domestic product (GDP). A total of 401 outpatients and 386 inpatients were included. Significant differences between countries were observed in the number of skin lesions among outpatients, ranging from 5.3% to 25.4% of patients with ≥250 lesions. Among inpatients, results were less variable. Average ambulatory medical visits ranged from 1.1 to 2.2. Average hospital stay ranged from 3.6 to 6.8 days. Use of tests/procedures was infrequent in outpatients, except in Argentina (13.3%); among inpatients, a test/procedure was ordered for 81.3% of patients, without regional variation. Prescription medications were administered in 44.4% of outpatients (range 9.3%–80.0%), and in 86% of inpatients (range 70.4%–94.9%). Total estimated spending on varicella treatment in the absence of vaccination was predicted from income levels (GDP) with an exponential function (R2 = 0.89). This study demonstrates that substantial HCRU is associated with varicella resulting in significant public health burden that could be alleviated through the use of varicella vaccination. Differences observed between countries possibly reflect treatment guidelines, healthcare resource availabilities and physician practices.http://dx.doi.org/10.1080/21645515.2018.1559687varicellapediatricshealthcare resource utilization (hcru)costsmulti-country |
| spellingShingle | Lara J. Wolfson Maria Esther Castillo Norberto Giglio Zsofia Meszner Zsuzsanna Molnar Mirella Vazquez Jacek Wysocki Alexandra Altland Barbara J. Kuter Jenaya Rickard Emmanouil Rampakakis Varicella healthcare resource utilization in middle income countries: a pooled analysis of the multi-country MARVEL study in Latin America & Europe Human Vaccines & Immunotherapeutics varicella pediatrics healthcare resource utilization (hcru) costs multi-country |
| title | Varicella healthcare resource utilization in middle income countries: a pooled analysis of the multi-country MARVEL study in Latin America & Europe |
| title_full | Varicella healthcare resource utilization in middle income countries: a pooled analysis of the multi-country MARVEL study in Latin America & Europe |
| title_fullStr | Varicella healthcare resource utilization in middle income countries: a pooled analysis of the multi-country MARVEL study in Latin America & Europe |
| title_full_unstemmed | Varicella healthcare resource utilization in middle income countries: a pooled analysis of the multi-country MARVEL study in Latin America & Europe |
| title_short | Varicella healthcare resource utilization in middle income countries: a pooled analysis of the multi-country MARVEL study in Latin America & Europe |
| title_sort | varicella healthcare resource utilization in middle income countries a pooled analysis of the multi country marvel study in latin america europe |
| topic | varicella pediatrics healthcare resource utilization (hcru) costs multi-country |
| url | http://dx.doi.org/10.1080/21645515.2018.1559687 |
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