title: The cost of seasonal respiratory illnesses in Australian children: the dominance of patient and family costs and implications for vaccine use.
abstract: Respiratory viral infections are one of the next group of diseases likely to be targeted for prevention in childhood by the use of vaccines. To begin collecting necessary epidemiology and cost information about the illnesses caused by these viruses, we conducted a prospective cohort study in 118 Melbourne children between 12 and 71 months of age during winter and spring 2001. We were interested in calculating an average cost per episode of community-managed acute respiratory disease, in identifying the key cost drivers of such illness, and to identify the proportion of costs borne by the patient and family. There were 202 community-managed influenza-like illnesses identified between July and December 2001, generating 89 general practitioner visits, and 42 antibiotic prescriptions. The average cost of community-managed episodes (without hospitalisation) was dollar 241 (95% CI dollar 191 to dollar 291), with the key cost drivers being carer time away from usual activities caring for the ill child (70% of costs), use of non-prescription medications (5.4%), and general practice visits (5.0%). The patient and family met 87 per cent of total costs. The lowest average cost occurred in households from the highest income bracket. Acute respiratory illness managed in the community is common, with the responsibility for meeting the cost of episodes predominantly borne by the patient and family in the form of lost productivity. These findings have implications for preventive strategies in children, such as the individual use of, or implementation of public programs using, currently available vaccines against influenza and vaccines under development against other viral respiratory pathogens.
authors.affiliation: Murdoch Childrens Research Institute, Royal Children's Hospital, Parkville, Victoria. s.lambert@unimelb.edu.au
authors.forename: Stephen
authors.initials: S
authors.lastname: Lambert
authors.forename: Kerry-Ann
authors.initials: KA
authors.lastname: O'Grady
authors.forename: Susan
authors.initials: S
authors.lastname: Gabriel
authors.forename: Robert
authors.initials: R
authors.lastname: Carter
authors.forename: Terry
authors.initials: T
authors.lastname: Nolan
mesh_terms: D017677:Age Distribution; D002675:Child, Preschool; D015331:Cohort Studies; D017046:Cost Savings; D017281:Cost of Illness; D003365:Costs and Cost Analysis; D005260:Female; D017048:Health Care Costs; D006801:Humans; D015994:Incidence; D007223:Infant; D007252:Influenza Vaccines / Q000008:administration & dosage / Q000191:economics*; D008297:Male; D011446:Prospective Studies; D012141:Respiratory Tract Infections / Q000191:economics* / Q000453:epidemiology / Q000517:prevention & control*; D012720:Severity of Illness Index; D017678:Sex Distribution; D014505:Urban Population; D014611:Vaccination / Q000191:economics*; D014739:Victoria / Q000453:epidemiology
chemical_list: D007252:Influenza Vaccines