Cost of management of severe pneumonia in young children: systematic analysis
Open Access
- 15 March 2016
- journal article
- review article
- Published by International Society of Global Health in Journal of Global Health
- Vol. 6 (1), 010408
- https://doi.org/10.7189/jogh.06.010408
Abstract
Childhood pneumonia is a major cause of childhood illness and the second leading cause of child death globally. Understanding the costs associated with the management of childhood pneumonia is essential for resource allocation and priority setting for child health. We conducted a systematic review to identify studies reporting data on the cost of management of pneumonia in children younger than 5 years old. We collected unpublished cost data on non–severe, severe and very severe pneumonia through collaboration with an international working group. We extracted data on cost per episode, duration of hospital stay and unit cost of interventions for the management of pneumonia. The mean (95% confidence interval, CI) and median (interquartile range, IQR) treatment costs were estimated and reported where appropriate. We identified 24 published studies eligible for inclusion and supplemented these with data from 10 unpublished studies. The 34 studies included in the cost analysis contained data on more than 95 000 children with pneumonia from both low– and–middle income countries (LMIC) and high–income countries (HIC) covering all 6 WHO regions. The total cost (per episode) for management of severe pneumonia was US$ 4.3 (95% CI 1.5–8.7), US$ 51.7 (95% CI 17.4–91.0) and US$ 242.7 (95% CI 153.6–341.4)–559.4 (95% CI 268.9–886.3) in community, out–patient facilities and different levels of hospital in–patient settings in LMIC. Direct medical cost for severe pneumonia in hospital inpatient settings was estimated to be 26.6%–115.8% of patients’ monthly household income in LMIC. The mean direct non–medical cost and indirect cost for severe pneumonia management accounted for 0.5–31% of weekly household income. The mean length of stay (LOS) in hospital for children with severe pneumonia was 5.8 (IQR 5.3–6.4) and 7.7 (IQR 5.5–9.9) days in LMIC and HIC respectively for these children. This is the most comprehensive review to date of cost data from studies on the management of childhood pneumonia and these data should be helpful for health services planning and priority setting by national programmes and international agencies.Keywords
This publication has 31 references indexed in Scilit:
- Does implementation of the IMCI strategy have an impact on child mortality? A retrospective analysis of routine data from EgyptBMJ Open, 2013
- The cost of outpatient pneumonia in children <5 years of age in FijiTropical Medicine & International Health, 2011
- Coping strategies for financial burdens in families with childhood pneumonia in BangladeshBMC Public Health, 2010
- Randomized Controlled Trial of Day Care Versus Hospital Care of Severe Pneumonia in BangladeshPublished by American Academy of Pediatrics (AAP) ,2010
- Burden of respiratory syncytial virus in hospitalized infants and young children in Amman, JordanScandinavian Journal of Infectious Diseases, 2010
- The economic burden of inpatient paediatric care: household and provider costs for treatment of pneumonia, malaria and meningitisCost Effectiveness and Resource Allocation, 2009
- Estimating average inpatient and outpatient costs and childhood pneumonia and diarrhoea treatment costs in an urban health centre in ZambiaCost Effectiveness and Resource Allocation, 2009
- Influenza-related disease: The cost to the Australian healthcare systemVaccine, 2008
- The cost of community-managed viral respiratory illnesses in a cohort of healthy preschool-aged childrenRespiratory Research, 2008
- Economic impact of community-acquired and nosocomial lower respiratory tract infections in young children in GermanyEuropean Journal of Pediatrics, 2005