Healthcare Resource Utilisation Associated with Herpes Zoster in a Prospective Cohort of Older Australian Adults

Herpes zoster (HZ) is a common condition that increases in incidence with older age but vaccines are available to prevent the disease. However, there are limited data estimating the health system burden attributable to herpes zoster by age. In this study, we quantified excess healthcare resource usa...

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Bibliographic Details
Published in:PloS one 2016-08, Vol.11 (8), p.e0160446-e0160446
Main Authors: Karki, Surendra, Newall, Anthony T, MacIntyre, C Raina, Heywood, Anita E, McIntyre, Peter, Banks, Emily, Liu, Bette
Format: Article
Language:English
Subjects:
Acute Disease
Adults
Age
Aged
Aged, 80 and over
Analysis
Australia
Care and treatment
Case-Control Studies
Cost analysis
Cost-Benefit Analysis - statistics & numerical data
Data collection
Delivery of Health Care - economics
Delivery of Health Care - utilization
Demographic aspects
Disease
Disease control
Emergency medical services
Emergency Service, Hospital - statistics & numerical data
Female
Health aspects
Health care
Health surveillance
Herpes zoster
Herpes Zoster - economics
Herpes Zoster - immunology
Herpes Zoster - physiopathology
Herpes Zoster - prevention & control
Herpes Zoster Vaccine - administration & dosage
Herpes Zoster Vaccine - economics
Herpesvirus 3, Human - pathogenicity
Herpesvirus 3, Human - physiology
Hospital costs
Hospitalization - economics
Hospitalization - statistics & numerical data
Humans
Immunization
Immunization - economics
Incidence
Male
Medical care utilization
Medicine
Medicine and Health Sciences
Middle Aged
Older people
Pain
People and Places
Pharmaceuticals
Physical Sciences
Population
Public health
Regression analysis
Regression models
Research and Analysis Methods
Risk factors
Studies
Surveillance
Vaccines
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Summary:Herpes zoster (HZ) is a common condition that increases in incidence with older age but vaccines are available to prevent the disease. However, there are limited data estimating the health system burden attributable to herpes zoster by age. In this study, we quantified excess healthcare resource usage associated with HZ during the acute/sub-acute period of disease (21days before to 90 days after onset) in 5952 cases and an equal number of controls matched on age, sex, and prior healthcare resource usage. Estimates were adjusted for potential confounders in multivariable regression models. Using population-based estimates of HZ incidence, we calculated the age-specific excess number of health service usage events attributable to HZ in the population. Per HZ case, there was an average of 0.06 (95% CI 0.04-0.08) excess hospitalisations, 1.61 (95% CI 1.51-1.69) excess general practitioner visits, 1.96 (95% CI 1.86-2.15) excess prescriptions filled and 0.11 (95% CI 0.09-0.13) excess emergency department visits. The average number of healthcare resource use events, and the estimated excess per 100,000 population increased with increasing age but were similar for men and women, except for higher rates of hospitalisation in men. The excess annual HZ associated burden of hospitalisations was highest in adults ≥80 years (N = 2244, 95%CI 1719-2767); GP visits was highest in those 60-69 years (N = 50567, 95%CI 39958-61105), prescriptions and ED visits were highest in 70-79 years (N = 50524, 95%CI 40634-60471 and N = 2891, 95%CI 2319-3449 respectively). This study provides important data to establish the healthcare utilisation associated with HZ against which detailed cost-effectiveness analyses of HZ immunisation in older adults can be conducted.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0160446