Costs of management of acute respiratory infections in older adults : A systematic review and meta-analysis
Copyright © 2022 by the Journal of Global Health. All rights reserved..
Background: Acute respiratory infections (ARIs) accounted for an estimated 3.9 million deaths worldwide in 2015, of which 56% occurred in adults aged 60 years or older. We aimed to identify the cost of ARI management in older adults (≥50 years) in order to develop an evidence base to assist decision-making for resource allocation and inform clinical practice.
Methods: We searched 8 electronic databases including Global Health, Medline and EMBASE for studies published between January 1, 2000 and December 31, 2021. Total management costs per patient per ARI episode were extracted and meta-analysis was conducted by World Health Organization (WHO) region and World Bank income level. All costs were converted and inflated to Euros (€) (2021 average exchange rate). The quality of included studies and the potential risk of bias were evaluated.
Results: A total of 42 publications were identified for inclusion, reporting cost data for 8 082 752 ARI episodes in older adults across 20 countries from 2001 to 2021. The majority (86%) of studies involved high-income countries based in Europe, North America and Western Pacific. The mean cost per episode was €17 803.9 for inpatient management and €128.9 for outpatient management. Compared with costs reported for patients aged <65 years, inpatient costs were €154.1, €7 018.8 and €8 295.6 higher for patients aged 65-74 years, 75-84 years and over 85 years. ARI management of at-risk patients with comorbid conditions and patients requiring higher level of care, incurred substantially higher costs for hospitalization: €735.9 and €1317.3 respectively.
Conclusions: ARIs impose a substantial economic burden on health systems, governments, patients and societies. This study identified high ARI management costs in older adults, reinforcing calls for investment by global health players to quantify and address the scale of the challenge. There are large gaps in data availability from low-income countries, especially from South East Asia and Africa regions.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:12 |
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| Enthalten in: |
Journal of global health - 12(2022) vom: 08. Nov., Seite 04096 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Zhang, Shanshan [VerfasserIn] |
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| Anmerkungen: |
Date Completed 09.11.2022 Date Revised 19.11.2022 published: Electronic Citation Status MEDLINE |
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| doi: |
10.7189/jogh.12.04096 |
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| Förderinstitution / Projekttitel: |
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NLM348565127 |
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| 100 | 1 | |a Zhang, Shanshan |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Costs of management of acute respiratory infections in older adults |b A systematic review and meta-analysis |
| 264 | 1 | |c 2022 | |
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| 500 | |a Date Revised 19.11.2022 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 by the Journal of Global Health. All rights reserved. | ||
| 520 | |a Background: Acute respiratory infections (ARIs) accounted for an estimated 3.9 million deaths worldwide in 2015, of which 56% occurred in adults aged 60 years or older. We aimed to identify the cost of ARI management in older adults (≥50 years) in order to develop an evidence base to assist decision-making for resource allocation and inform clinical practice | ||
| 520 | |a Methods: We searched 8 electronic databases including Global Health, Medline and EMBASE for studies published between January 1, 2000 and December 31, 2021. Total management costs per patient per ARI episode were extracted and meta-analysis was conducted by World Health Organization (WHO) region and World Bank income level. All costs were converted and inflated to Euros (€) (2021 average exchange rate). The quality of included studies and the potential risk of bias were evaluated | ||
| 520 | |a Results: A total of 42 publications were identified for inclusion, reporting cost data for 8 082 752 ARI episodes in older adults across 20 countries from 2001 to 2021. The majority (86%) of studies involved high-income countries based in Europe, North America and Western Pacific. The mean cost per episode was €17 803.9 for inpatient management and €128.9 for outpatient management. Compared with costs reported for patients aged <65 years, inpatient costs were €154.1, €7 018.8 and €8 295.6 higher for patients aged 65-74 years, 75-84 years and over 85 years. ARI management of at-risk patients with comorbid conditions and patients requiring higher level of care, incurred substantially higher costs for hospitalization: €735.9 and €1317.3 respectively | ||
| 520 | |a Conclusions: ARIs impose a substantial economic burden on health systems, governments, patients and societies. This study identified high ARI management costs in older adults, reinforcing calls for investment by global health players to quantify and address the scale of the challenge. There are large gaps in data availability from low-income countries, especially from South East Asia and Africa regions | ||
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Wahi-Singh, Pia |e verfasserin |4 aut | |
| 700 | 1 | |a Wahi-Singh, Bhanu |e verfasserin |4 aut | |
| 700 | 1 | |a Chisholm, Alison |e verfasserin |4 aut | |
| 700 | 1 | |a Keeling, Polly |e verfasserin |4 aut | |
| 700 | 1 | |a Nair, Harish |e verfasserin |4 aut | |
| 700 | 0 | |a RESCEU Investigators |e verfasserin |4 aut | |
| 700 | 1 | |a Nair, Harish |e investigator |4 oth | |
| 700 | 1 | |a Campbell, Harry |e investigator |4 oth | |
| 700 | 1 | |a Shi, Ting |e investigator |4 oth | |
| 700 | 1 | |a Zhang, Shanshan |e investigator |4 oth | |
| 700 | 1 | |a Li, You |e investigator |4 oth | |
| 700 | 1 | |a Wang, Xin |e investigator |4 oth | |
| 700 | 1 | |a Openshaw, Peter |e investigator |4 oth | |
| 700 | 1 | |a Wedzicha, Jadwicha |e investigator |4 oth | |
| 700 | 1 | |a Beutels, Philippe |e investigator |4 oth | |
| 700 | 1 | |a Bont, Louis |e investigator |4 oth | |
| 700 | 1 | |a Pollard, Andrew |e investigator |4 oth | |
| 700 | 1 | |a Molero, Eva |e investigator |4 oth | |
| 700 | 1 | |a Martinon-Torres, Federico |e investigator |4 oth | |
| 700 | 1 | |a Heikkinen, Terho |e investigator |4 oth | |
| 700 | 1 | |a Meijer, Adam |e investigator |4 oth | |
| 700 | 1 | |a Fischer, Thea Kølsen |e investigator |4 oth | |
| 700 | 1 | |a van den Berge, Maarten |e investigator |4 oth | |
| 700 | 1 | |a Giaquinto, Carlo |e investigator |4 oth | |
| 700 | 1 | |a Mikolajczyk, Rafael |e investigator |4 oth | |
| 700 | 1 | |a Abram, Michael |e investigator |4 oth | |
| 700 | 1 | |a Swanson, Kena |e investigator |4 oth | |
| 700 | 1 | |a Leach, Amanda |e investigator |4 oth | |
| 700 | 1 | |a Stoszek, Sonia |e investigator |4 oth | |
| 700 | 1 | |a Gallichan, Scott |e investigator |4 oth | |
| 700 | 1 | |a Kieffer, Alexia |e investigator |4 oth | |
| 700 | 1 | |a Demont, Clarisse |e investigator |4 oth | |
| 700 | 1 | |a Cheret, Arnaud |e investigator |4 oth | |
| 700 | 1 | |a Gavart, Sandra |e investigator |4 oth | |
| 700 | 1 | |a Aerssens, Jeroen |e investigator |4 oth | |
| 700 | 1 | |a Rosen, Brian |e investigator |4 oth | |
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