title: Cost of hospitalizing children with invasive pneumococcal pneumonia.
abstract: BACKGROUND
  Although invasive pneumococcal pneumonia remains responsible for a significant number of child hospitalizations, specific data on hospital resource utilization and related costs are limited.
  
  
  OBJECTIVE
  To assess the cost of hospitalizing children with invasive pneumococcal pneumonia and identify the cost determinants of the disease.
  
  
  METHODS
  Economic evaluation based on an observational study of all children <18 years of age with culture-proved invasive pneumococcal pneumonia admitted to a referral hospital in Barcelona (Spain) during the period January 2001-December 2011. Analysis included demographic, microbiological, epidemiological and clinical variables.
  
  
  RESULTS
  A total of 135 children were included in the study (median age 3.3 years). PCV13 serotypes were detected in 132 (97.8%) cases. Median hospital cost was €4533 (€4078-5435, 95% CI). Median length of stay was 11.0 days (10.6-13.0 days, 95% CI). Variables significantly associated with increased cost in the multivariate analysis were complicated pneumonia (≥2 and 1 complication) versus non-complicated pneumonia (€4919 and €2822 vs. €1399), performance of surgery versus no surgery (€4849 vs. €1435), intensive care versus no intensive care (€6488 vs. €3862) and identification of non-PCV7 serotypes versus PCV7 serotypes (€4656 vs. €1470).
  
  
  CONCLUSIONS
  Invasive pneumococcal pneumonia in children makes substantial demands on hospital health care and financial resources that could be mitigated with universal PCV13 childhood immunization programmes and early management of complications.
authors.affiliation: Department of Microbiology, Hospital Sant Joan de Déu-University of Barcelona, Esplugues, Barcelona, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Brotons
authors.forename: Gemma
authors.initials: G
authors.lastname: Gelabert
authors.forename: Cristian
authors.initials: C
authors.lastname: Launes
authors.forename: Elisa
authors.initials: E
authors.lastname: Sicuri
authors.forename: Roman
authors.initials: R
authors.lastname: Pallares
authors.forename: Carmen
authors.initials: C
authors.lastname: Muñoz-Almagro
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics*; D006761:Hospitals; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay; D008297:Male; D011018:Pneumonia, Pneumococcal / Q000150:complications / Q000191:economics* / Q000628:therapy*; D013030:Spain