title: Economic burden of herpes zoster among skilled nursing facility residents in the United States.
abstract: OBJECTIVE
  To evaluate health care resource use and direct medical costs attributable to herpes zoster (HZ) among elderly residents of skilled nursing facilities (SNF).
  
  
  METHODS
  This was a retrospective matched cohort study using data from 300 SNF in the United States. A total of 404 patients with HZ were matched with 1616 patients with no documented HZ or post-herpetic neuralgia using propensity scores. The study period included a 1-month pre-index period and the 90-day acute/subacute phase following the HZ index date. Health care resource utilization was captured from the long term care minimum dataset (MDS) and SNF admission-discharge records. The direct medical costs consisted of the SNF net bed revenue and hospitalization cost.
  
  
  RESULTS
  Over the 4-month study period, significantly more patients were hospitalized among the HZ (20.5%) than non-HZ cohort (14.4%). Both the numbers of hospitalization episodes and hospitalization days were greater for HZ than for non-HZ patients. An average additional 0.09 hospitalization episodes and 0.55 days of hospitalization were estimated in a multivariate model for patients in the HZ compared with the non-HZ cohort. The incremental direct medical costs, which are composed of the incremental medical costs incurred in the SNF, and the incremental costs attributable to hospitalization, were estimated between $1079 and $1673 for patients with HZ.
  
  
  CONCLUSIONS
  In the SNF setting, the presence of HZ imposes significant health care resource utilization and direct medical costs.
authors: Merck & Co., Inc., Whitehouse Station, NJ, USA. larry_ma@merck.com
authors: Liyuan
authors: L
authors: Ma
authors: Ronald R
authors: RR
authors: White
authors: Siva
authors: S
authors: Narayanan
authors: Kenneth E
authors: KE
authors: Schmader
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D015331:Cohort Studies; D017281:Cost of Illness; D005260:Female; D017048:Health Care Costs; D006295:Health Resources / Q000706:statistics & numerical data; D006562:Herpes Zoster / Q000191:economics* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012866:Skilled Nursing Facilities / Q000191:economics; D014481:United States