Cost of care and clinical condition in paediatric cystic fibrosis patients.
BACKGROUND
The clinical course of cystic fibrosis (CF) shows considerable variation resulting in differences in health care utilisation. We investigated important clinical parameters and their relation to costs.


METHODS
We collected clinical parameters together with health care utilisation of a representative paediatric CF population (n=138 patients) attending Hanover Medical School over a period of 1 year. 49% of the patients were chronically infected with Pseudomonas aeruginosa. Costs were calculated on the basis of the annual individual health care utilisation from the perspective of health insurance.


RESULTS
Total annual expenditure per patient amounted to 23,989 euro (S.D. 18,026), with home drug treatment representing the most important single cost factor (47% of total costs). While costs rose with age and doubled in the first 18 years, they correlated foremost with P. aeruginosa airway colonisation status and lung function expressed as FEV(1). Costs of patients with chronic P. aeruginosa infection were more than three times higher than of uninfected patients.


CONCLUSIONS
Health care expenditures for patients with CF vary with the clinical course. The variation can be explained to a large extend by clinical parameters.
Department of Paediatric Pulmonology and Neonatology, Hanover Medical School, 30623 Hannover, Germany. baumann.ulrich@mh-hannover.de
Ulrich
U
Baumann
Christiane
C
Stocklossa
Wolfgang
W
Greiner
Johann-Matthias Graf
JM
von der Schulenburg
Horst
H
von der Hardt
D000293:Adolescent; D000367:Age Factors; D001835:Body Weight; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003550:Cystic Fibrosis / Q000150:complications / Q000191:economics* / Q000628:therapy; D005260:Female; D005541:Forced Expiratory Volume; D005858:Germany; D017048:Health Care Costs / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006304:Health Status; D006785:Hospitals, University; D006801:Humans; D007348:Insurance, Health / Q000191:economics; D008297:Male; D009752:Nutritional Status; D017063:Outcome Assessment, Health Care; D011552:Pseudomonas Infections / Q000191:economics* / Q000209:etiology / Q000628:therapy; D011550:Pseudomonas aeruginosa; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index