Cost of hospitalizing children with invasive pneumococcal pneumonia

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.

Objectives: To assess the cost of hospitalizing children with invasive pneumococcal pneumonia and identify the cost determinants of the disease.

Patients and 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).

Conclusion: 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.