The disease burden of pertussis in adults 50 years old and older in the United States: a retrospective study

被引:43
作者
McGuiness, Catherine Balderston [1 ]
Hill, Jerrold [1 ]
Fonseca, Eileen [1 ]
Hess, Gregory [1 ,2 ]
Hitchcock, William [3 ]
Krishnarajah, Girishanthy [4 ]
机构
[1] IMS Hlth, Plymouth Meeting, PA 19462 USA
[2] Univ Penn, Leonard Davis Inst Hlth Econ & Policy, Philadelphia, PA 19104 USA
[3] La Jolla Pediat, San Diego, CA 92121 USA
[4] GlaxoSmithKline, Philadelphia, PA 19104 USA
关键词
Pertussis; Whooping cough; Health economics; Adults; Elderly; WHOOPING-COUGH; ADOLESCENTS; EPIDEMIOLOGY; VACCINATION; MORBIDITY;
D O I
10.1186/1471-2334-13-32
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Background: While the incidence of pertussis has increased in adolescents and adults in recent years in the U.S., little is known about the incidence and economic burden of pertussis in older adults. This study provides evidence of the incidence of pertussis and direct medical charges associated with pertussis episodes of care (PEOCs) in adults aged 50 years and older in the U.S. Methods: PEOCs were divided into periods before and after the initial pertussis diagnosis was made (i.e., the index date) to capture any conditions immediately preceding the pertussis diagnosis that may have represented misdiagnoses and subsequent conditions that may have represented sequelae. Data were extracted from IMS's recently acquired SDI databases of longitudinal, patient-level practitioner claims and hospital operational billing records collected from private practitioners and hospitals, respectively, across the U.S. Patients 50 years and older with one or more ICD-9-CM diagnoses for pertussis/whooping cough and/or a laboratory test positive for Bordetella pertussis between 1/1/2006 and 10/31/2010 were eligible for study inclusion. Resource utilization and charges (i.e., unadjudicated claims) associated with the patient's physician and hospital care were analyzed. The nationally projected incidence of pertussis was estimated using a subsample of patients with the required data necessary for projection. Results: Estimated incidence of diagnosed pertussis ranged from 2.1-4.6 cases per 100,000 people across the two age groups (50-64 and [greater than or equal to] 65) during the years 2006 to 2010. The analysis of charges included 5,748 patients [greater than or equal to] 50 years of age with pertussis. Average charges across the entire episode of care were $1,835 and $14,428 per patient in the outpatient and inpatient settings, respectively. The average number of outpatient (i.e., private practitioner) visits was 2 per patient in both the pre-index and post-index periods. Conclusions: In the U.S., the incidence of diagnosed pertussis in adults 50 years and older has increased between 2006 and 2010. Healthcare utilization and charges associated with pertussis are substantial, suggesting the need for additional prevention and control strategies and a higher degree of clinical awareness on the part of health care providers. Additional research regarding pertussis in older populations is needed to substantiate these findings.
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页数:14
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共 30 条
[11]   Changing epidemiology of pertussis in the United States:: Increasing reported incidence among adolescents and adults, 1990-1996 [J].
Güris, D ;
Strebel, PM ;
Bardenheier, B ;
Brennan, M ;
Tachdjian, R ;
Finch, E ;
Wharton, M ;
Livengood, JR .
CLINICAL INFECTIOUS DISEASES, 1999, 28 (06) :1230-1237
[12]  
Heininger U, 2010, EXPERT REV ANTI-INFE, V8, P163, DOI [10.1586/eri.09.124, 10.1586/ERI.09.124]
[13]  
Hong Jung Yun, 2010, Korean J Pediatr, V53, P629, DOI 10.3345/kjp.2010.53.5.629
[14]  
Infectious Disease Society of America, ACIP REC TDAP ALL AD
[15]   DURATION OF EFFECTIVENESS OF PERTUSSIS-VACCINE - EVIDENCE FROM A 10 YEAR COMMUNITY STUDY [J].
JENKINSON, D .
BRITISH MEDICAL JOURNAL, 1988, 296 (6622) :612-614
[16]   NATURAL COURSE OF 500 CONSECUTIVE CASES OF WHOOPING-COUGH - A GENERAL-PRACTICE POPULATION STUDY [J].
JENKINSON, D .
BRITISH MEDICAL JOURNAL, 1995, 310 (6975) :299-302
[17]   Societal costs and morbidity of pertussis in adolescents and adults [J].
Lee, GM ;
Lett, S ;
Schauer, S ;
LeBaron, C ;
Murphy, TV ;
Rusinak, D ;
Lieu, TA .
CLINICAL INFECTIOUS DISEASES, 2004, 39 (11) :1572-1580
[18]  
McNabb Scott J. N., 2006, Morbidity and Mortality Weekly Report, V55, P1
[19]  
Miller E, 2000, Commun Dis Public Health, V3, P132
[20]   Progress in the diagnosis, prevention, and treatment of pertussis [J].
Flor M. Munoz ;
Wendy A. Keitel .
Current Infectious Disease Reports, 2003, 5 (3) :213-219