Treatment costs of diarrheal disease and all-cause pneumonia among children under-5 years of age in Colombia

Objective: We estimate treatment costs associated with diarrheal disease and all-cause pneumonia among children under-5 years of age in Colombia and assess similarities or differences with previous cost estimations in developing countries of the Americas. Methods: Macro-costing methods were used to carry out an analysis of diarrhea and all-cause pneumonia costs in Colombia in 2010. The perspective of the health care system was taken. Data were extracted from a health insurer database that includes information on health service utilization among 130,800 children from low-income households. Lengths of stay for hospital admissions and frequencies of cases at all levels of care registered in the database were estimated. Results: There were 1456 diarrheal disease cases among the 130,800 children (aged >= 60 months) included in the study. The median cost per case was $27.10 (interquartile range [IQR]: $15.60-77.40). A total of 1545 all-cause pneumonia cases were reported to the insurer in 2010, resulting in a frequency of 1181 cases per 100,000 children (95% confidence interval [CI] = 1122, 1240). The overall cost of all-cause pneumonia cases was $858,791, and the median cost per case treated was $263 (IQR: $27-546). Comparisons by level of care showed that costs were significantly different for the two diseases (p < .05). Costs for the diseases did not differ by age group (p > .05). Conclusions: Diarrhea and all-cause pneumonia constitute a significant economic and health burden in Colombia. The relatively large size of our sample allowed us to provide reliable national estimates of the costs associated with these diseases. Our results for Colombia are similar to previous estimates from developing countries in the Americas. These data provide valid estimates that may be used decision makers in other countries to make appropriate recommendations on the introduction of rotavirus and pneumococcal vaccines. (C) 2013 Elsevier Ltd. All rights reserved.