PIH13 CLINICAL BURDEN AND COSTS ASSOCIATED WITH PNEUMOCOCCAL DISEASE HOSPITALIZATIONS IN OLDER ADULTS IN CURITIBA, BRAZIL

Abstract

The objective of this study was to evaluate the clinical burden and costs associated with pneumococcal disease hospitalizations among adults 60+ years old in Curitiba from the public healthcare perspective. An analysis of public hospital admissions in Curitiba for invasive pneumococcal disease and potential pneumococcal pneumonia was developed according to ICD-10 classification (pneumonia: J13, J15 to J18; invasive pneumococcal disease [IPD]: G.001, A40.3, and B95.3), as reported in Brazilian Hospital Information System (SIH/DATASUS) database from January 2014 to December 2017. Data were stratified by age group, calendar year, and type of event (pneumonia and IPD). In this population, there were 4,559 hospital admissions in the period. Of these, 4,548 (99.8%) was due to pneumonia. The average hospital admissions and deaths were 1140 and 245, respectively. The case fatality rate was 21.5%, increasing with age from 11.5% in 60-64y to 29.6% in 80y+. The average length of stay was 8 days. The 2014-2017 total admissions cost was R$ 6,150,793.63 (US $1,654,150.60), with the average cost per year of R$ 1,537,698.16 (US $413,537.58). The mean cost per case/ type of event was R$1,339.07 (US $360.12) for pneumonia and R$ 5,519.43 (US $1,484.36) for IPD. Older adults accounted for 35% and 87% of hospitalizations and deaths in all age groups versus 42% and 2% in children under 5 years of age, respectively. Thirty-eight percent of the total cost was related to admissions in 60y+. The clinical burden and associated cost with pneumococcal disease hospitalizations is substantial in older adults. In Brazil, only adults with chronic diseases and immunosuppressive conditions have access to publicly-funded pneumococcal immunization programs. Development of specific policies regarding preventive measures in this population are fundamental.