VARICELLA-RELATED HEALTH CARE RESOURCE UTILIZATION IN PERU

• Published in: Value in health 2017-05, Vol.20 (5), p.A288
• Main Authors: Castillo, ME, Gutierrez, R, Monsanto, H, Rampakakis, E, Altland, A, Wolfson, LJ
• Format: Article
• Language: English
• Subjects: Allied health professionals; Averages; Chart reviews; Chicken pox; Childhood; Children; Complications; Encephalitis; Health care; Health initiatives; Health services utilization; Help seeking behavior; Immunization; Inpatient care; Medical diagnosis; Medical personnel; Morbidity; Mortality; Outpatients; Over the counter sales; Pneumonia; Public health; Resource utilization; Skin; Vaccines; Varicella
• ISSN: 1098-3015; 1524-4733
• DOI: 10.1016/j.jval.2017.05.005

OBJECTIVES: Varicella-zoster virus (VZV) is a serious health concern that results in considerable burden to public health systems, with a minimal estimate of 375,000 cases per year in children under 15 in Peru. Since the introduction of safe and effective varicella vaccines, several countries have implemented routine childhood varicella immunization programs that have drastically reduced asso­ciated morbidity and mortality. Peru currently does not include the varicella vaccine in their public childhood immunization schedule. The purpose of this study was to evaluate the burden of illness associated with varicella in Peru. METHODS: This was a multicenter, retrospective chart review study of patients aged 1-12 years with a primary varicella diagnosis between 2011 and 2016 in Peru. Clinical complications due to varicella, along with associated healthcare resource utilization (HCRU) were assessed in both the inpatient and outpatient settings using summary statistics. RESULTS: A total of 179 children with varicella (101 outpatients, 78 inpatients) from 9 centers (6 public, 3 private), were included in the study, with a mean age of 3.3 (SD: 3.3) and 2.4 (SD: 3.4) years, respectively. Among outpatients, 5.9% experienced at least one complication, specifically skin and soft tissue infections (100% of those experiencing complications), compared with 96.2% of inpatients, among which the most common complications included skin and soft tissue infections (75.3%), pneumonia (6.2%), and encephalitis (3.7%). HCRU estimates included use of over-the-counter (OTC) medications (72.3% outpatients, 89.7% inpatients), prescription medications (30.7% outpatients, 94.9% inpatients), tests/procedures (0.0% outpatients, 80.8% inpatients), and consultation with allied health professionals (0.0% outpatients, 39.7% inpatients). The average duration of hospital stay was 6.8 (95% CI: 5.8 , 8.0) days for inpatients. CONCLUSIONS: Varicella is associated with substantial clinical com­plications and healthcare resource utilization in Peru, subsequently indicating a significant health and economic burden, which supports the need for the implementation of a routine childhood varicella vaccination plan.