title: The cost of hospital care for management of invasive group A streptococcal infections in England.
abstract: The objective of this study was to estimate the direct financial costs of hospital care for management of invasive group A streptococcal (GAS) infections using hospital records for cases diagnosed in England. We linked laboratory-confirmed cases (n = 3696) identified through national surveillance to hospital episode statistics and reimbursement codes. From these codes we estimated the direct hospital costs of admissions. Almost all notified invasive GAS cases (92% of 3696) were successfully matched to a primary hospital admission. Of these, secondary admissions (within 30 days of primary admission) were further identified for 593 (17%). After exclusion of nosocomial cases (12%), the median costs of primary and secondary hospital admissions were estimated by subgroup analysis as £1984-£2212 per case, totalling £4·43-£6·34 million per year in England. With adjustment for unmatched cases this equated to £4·84-£6·93 million per year. Adults aged 16-64 years accounted for 48% of costs but only 40% of cases, largely due to an increased number of surgical procedures. The direct costs of hospital admissions for invasive GAS infection are substantial. These estimated costs will contribute to a full assessment of the total economic burden of invasive GAS infection as a means to assess potential savings through prevention measures.
authors.affiliation: Field Epidemiology Training Programme,Public Health England,Colindale,London,UK.
authors.forename: G J
authors.initials: GJ
authors.lastname: Hughes
authors.affiliation: Health Protection Directorate,Public Health England,Colindale,London,UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: VAN Hoek
authors.affiliation: Imperial College Faculty of Medicine,Hammersmith Hospital,London,UK.
authors.forename: S
authors.initials: S
authors.lastname: Sriskandan
authors.affiliation: Health Protection Directorate,Public Health England,Colindale,London,UK.
authors.forename: T L
authors.initials: TL
authors.lastname: Lamagni
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003422:Critical Care / Q000191:economics*; D004739:England / Q000453:epidemiology; D019115:Fasciitis, Necrotizing / Q000191:economics* / Q000453:epidemiology; D005260:Female; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D018410:Pneumonia, Bacterial / Q000191:economics* / Q000453:epidemiology; D018805:Sepsis / Q000191:economics* / Q000453:epidemiology; D018461:Soft Tissue Infections / Q000191:economics* / Q000453:epidemiology; D013290:Streptococcal Infections / Q000191:economics* / Q000453:epidemiology; D013297:Streptococcus pyogenes; D055815:Young Adult
keywords: treatment costs