PIN42 - Pertussis in Brazilian Children: Mortality, Length of Stay, and Costs in Hospitalized Patients

Abstract

Bordetella pertussisinfection is highly contagious and can progress to severe conditions, especially among young children and elderly. This study aims to describe hospitalization patterns and costs for pertussis in children in public hospitals in Brazil, from 2008 to 2011. A retrospective analysis of Brazil public hospital admissions for pertussis was developed according to ICD-10 classification (A37: Pertussis) in children (aged ≤9 years), as reported in Brazilian Hospital Information System (SIH/DATASUS) database from January 2008 to December 2011. Costs represents federal reimbursement values for hospitalizations (includes medical procedures, exams, medications and taxes), presented in 2013 Brazilian Real (BRL). A total of 3055 hospital admissions for pertussis during the four-year period were identified. There was a downward trend in the first three years of the analysis, while the opposite occurred in the fourth year, with 2011 having the highest number of cases (907, 655, 394 and 1,099 for 2008, 2009, 2010, and 2011, respectively). Infants were the most affected, with those less than one year of age accounting for 91% (n = 2,779) of all pertussis admissions in the age group analyzed. In-hospital mortality rate was 13.9% for all cause in the period. Mean length of stay was 7.56 days. Total cost for the period was 3,754,877 BRL, which represents 94.9% of pertussis hospitalization costs for all ages (3,958,133 BRL). Mean cost per patient was 1,229 BRL. The costs with pertussis hospitalizations in children can be substantial in Brazil, from the public health care perspective. Despite the existence of a National Immunization Program, the number of cases in children remains high. It is therefore important that decision makers reassess the prevention and treatment patterns of this disease.