Burden of herpes zoster: the direct and comorbidity costs of herpes zoster events in hospitalized patients over 50 years in France.
BACKGROUND
The objectives of this study were to describe hospital stays related to HZ and to evaluate the direct and indirect cost of hospitalizations due to HZ among patients aged over 50 years.


METHODS
The hospitalizations of people aged over 50 years were selected from the French national hospital 2011 database (PMSI) using ICD-10 diagnosis codes for HZ. Firstly, stays with HZ as principal or related diagnostic were described through the patient characteristics, type of hospitalization and the related costs. Secondly, a retrospective case-control analysis was performed on stays with HZ as comorbidity in 5 main hospitalizations causes (circulatory, respiratory, osteo-articular, digestive systems and diabetes) to assess the impact of HZ as co-morbidity on the length of stay, mortality rate and costs.


RESULTS
In the first analysis, 2,571 hospital stays were collected (60 % of women, mean age: 76.3 years and mean LOS: 9.5 days). The total health assurance costs were 10,8 M€. Mean cost per hospital stay was 4,206€. In the second analysis, a significant difference in LOS and costs was shown when HZ was associated as comorbidity in other hospitalization's causes.


CONCLUSIONS
HZ directly impacts on the hospital cost. When present as comorbidity for other medical reasons, HZ significantly increases the length of hospital stay with subsequent economic burden for the French Health System.
HEVA, Lyon, France. cblein@hevaweb.com.
Cecile
C
Blein
Université de Grenoble-Alpes et GREPI, clinique universitaire de médecine gériatrique, CHU de Grenoble, la tronche, France. ggavazzi@chu-grenoble.fr.
Gaetan
G
Gavazzi
Geriatrics Department University Hospital La Milétrie, Poitiers, France. Marc.PACCALIN@chu-poitiers.fr.
Marc
M
Paccalin
Sanofi Pasteur MSD, Lyon, France. CBaptiste@spmsd.com.
Charles
C
Baptiste
Hôpital Saint Jacques, CHU de Nantes, Nantes, France. gilles.berrut@chu-nantes.fr.
Gilles
G
Berrut
HEVA, Lyon, France. AVAINCHTOCK@hevaweb.com.
Alexandre
A
Vainchtock
D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000401:mortality; D016022:Case-Control Studies; D015897:Comorbidity; D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000401:mortality; D004066:Digestive System Diseases / Q000453:epidemiology / Q000401:mortality; D020804:Encephalitis, Varicella Zoster / Q000191:economics* / Q000453:epidemiology; D005260:Female; D005602:France / Q000453:epidemiology; D017048:Health Care Costs; D006562:Herpes Zoster / Q000191:economics* / Q000453:epidemiology; D014645:Herpesvirus 3, Human; D017721:Hospital Costs; D006760:Hospitalization / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000191:economics*; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology / Q000401:mortality; D010361:Patients; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000401:mortality; D012189:Retrospective Studies