title: Costs of dengue in three French territories of the Americas: an analysis of the hospital medical information system (PMSI) database.
abstract: BACKGROUND
  Dengue is a major emerging public health concern in tropical and subtropical countries. Severe dengue can lead to hospitalisation and death. This study was performed to assess the economic burden of hospitalisations for dengue from 2007 to 2011 in three French territories of the Americas where dengue is endemic (French Guiana, Martinique and Guadeloupe).
  
  
  METHODS
  Data on dengue-associated hospitalisations were extracted from the French national hospital administrative database, Programme de Médicalisation des Systèmes d'Information (PMSI). The numbers of stays and the corresponding number of hospitalised patients were determined using disease-specific ICD-10 codes. Associated hospital costs were estimated from the payer perspective, using French official tariffs.
  
  
  RESULTS
  Overall, 4183 patients (mean age 32 years; 51 % male) were hospitalised for dengue, corresponding to 4574 hospital stays. In nearly all hospital stays (98 %; 4471), the illness was medically managed and the mean length of stay was 4.3 days. The mean cost per stay was €2522, corresponding to a total hospital cost of €11.5 million over the 5 years assessed. The majority of hospitalisations (80 % of patients) and associated costs (75 % of total hospital costs) were incurred during two epidemics.
  
  
  CONCLUSIONS
  Severe dengue is associated with significant hospital costs that escalate during outbreaks.
authors.affiliation: Global Health Sanofi Pasteur, Lyon, 69007, France.
authors.forename: M
authors.initials: M
authors.lastname: Uhart
authors.affiliation: Health Economist, HEVA, 186 Avenue Thiers, 69465 Lyon Cedex 06, France. cblein@hevaweb.com.
authors.forename: C
authors.initials: C
authors.lastname: Blein
authors.affiliation: Global Epidemiologist, Sanofi Pasteur, Lyon 69007, France.
authors.forename: M
authors.initials: M
authors.lastname: L'Azou
authors.affiliation: Former head of the emergency department, Centre Hospitalier Universitaire, 97200 Fort-De-France, Martinique.
authors.forename: L
authors.initials: L
authors.lastname: Thomas
authors.affiliation: Global Health Economist, Sanofi Pasteur, Lyon 69007, France.
authors.forename: L
authors.initials: L
authors.lastname: Durand
mesh_terms: D000293:Adolescent; D000569:Americas / Q000453:epidemiology; D018595:Colonialism; D003365:Costs and Cost Analysis; D016208:Databases, Factual; D003715:Dengue / Q000191:economics* / Q000453:epidemiology*; D005260:Female; D005602:France; D017721:Hospital Costs; D006751:Hospital Information Systems; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000639:trends; D008297:Male
keywords: Dengue; Economic burden; French Guiana; Guadeloupe and Martinique; Hospitalisation cost