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Prevalence, healthcare resource utilization and overall burden of fungal meningitis in the United States.

ABSTRACT: PURPOSE:Previous epidemiological and cost studies of fungal meningitis have largely focused on single pathogens, leading to a poor understanding of the disease in general. We studied the largest and most diverse group of fungal meningitis patients to date, over the longest follow-up period, to examine the broad impact on resource utilization within the United States. METHODOLOGY:The Truven Health Analytics MarketScan database was used to identify patients with a fungal meningitis diagnosis in the United States between 2000 and 2012. Patients with a primary diagnosis of cryptococcal, Coccidioides, Histoplasma, or Candida meningitis were included in the analysis. Data concerning healthcare resource utilization, prevalence and length of stay were collected for up to 5 years following the original diagnosis. RESULTS:Cryptococcal meningitis was the most prevalent type of fungal meningitis (70.1?% of cases over the duration of the study), followed by coccidioidomycosis (16.4?%), histoplasmosis (6.0?%) and candidiasis (7.6?%). Cryptococcal meningitis and candidiasis patients accrued the largest average charges ($103?236 and $103?803, respectively) and spent the most time in the hospital on average (70.6 and 79?days). Coccidioidomycosis and histoplasmosis patients also accrued substantial charges and time in the hospital ($82?439, 48.1?days; $78?609, 49.8?days, respectively). CONCLUSION:Our study characterizes the largest longitudinal cohort of fungal meningitis in the United States. Importantly, the health economic impact and long-term morbidity from these infections are quantified and reviewed. The healthcare resource utilization of fungal meningitis patients in the United States is substantial.

SUBMITTER: Charalambous LT

PROVIDER: S-EPMC6557145 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

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Prevalence, healthcare resource utilization and overall burden of fungal meningitis in the United States.

Charalambous Lefko T LT Premji Alykhan A Tybout Caroline C Hunt Anastasia A Cutshaw Drew D Elsamadicy Aladine A AA Yang Siyun S Xie Jichun J Giamberardino Charles C Pagadala Promila P Perfect John R JR Lad Shivanand P SP

Journal of medical microbiology 20171215 2

<h4>Purpose</h4>Previous epidemiological and cost studies of fungal meningitis have largely focused on single pathogens, leading to a poor understanding of the disease in general. We studied the largest and most diverse group of fungal meningitis patients to date, over the longest follow-up period, to examine the broad impact on resource utilization within the United States.<h4>Methodology</h4>The Truven Health Analytics MarketScan database was used to identify patients with a fungal meningitis ...[more]

PMID: 29244019

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Project description:Despite several studies that have estimated the economic impact of Respiratory Syncytial Virus (RSV) in infants, limited data are available on healthcare resource use and costs attributable to RSV across age groups. The aim of this study was to quantify age-specific RSV-related healthcare resource use and costs on the US healthcare system.This retrospective case-control study identified patients aged ?1 year with an RSV event in the Truven Health Marketscan® Commercial Claims and Encounters and Medicare Supplemental and Coordination of Benefits databases between August 31, 2012 and August 1, 2013. RSV patients were matched 1:1 with non-RSV controls for age, gender, region, healthcare plan and index date (n?=?11,432 in each group). Stratified analyses for healthcare resource use and costs were conducted by age groups. RSV-attributable resource use and costs were assessed based on the incremental differences between RSV cases and controls using multivariate analysis.RSV patients had a higher healthcare resource use (hospital stays, emergency room/urgent care visits, ambulatory visits and outpatient visits) than non-RSV matched controls for all age groups (all p?<?0.0001), particularly in the elderly age groups with RSV (1.9 to 3 days length of stay, 0.4 to 0.5 more ER/UC visits, 0.7 to 2.7 more ambulatory visits, 12.1 to 18.6 more outpatient visits and 9.5 to 14.6 more prescriptions than elderly in the control groups). The incremental difference in adjusted mean annual costs between RSV and non-RSV controls was higher in elderly (?65; $12,030 to $23,194) than in those aged <?65 years ($2251 to $5391). Among children, adjusted costs attributable to RSV were higher in children aged 5-17 years ($3192), than those 1-4 years ($2251 to $2521).Our findings showed a substantial annual RSV-attributable healthcare resource use and costs in the US across age groups, with the highest burden in those aged ?65 years. These data can be used in cost-effectiveness analyses, and may be useful for policymakers to guide future RSV vaccination and other prevention programs.

Dataset Information

Prevalence, healthcare resource utilization and overall burden of fungal meningitis in the United States.

Publications

Prevalence, healthcare resource utilization and overall burden of fungal meningitis in the United States.

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