Título

THE PUBLIC HEALTH AND ECONOMIC IMPACT OF PNEUMOCOCCAL DISEASE HOSPITALIZATIONS IN THE POPULATION 60 YEARS AND OLDER IN THE CITY OF CURITIBA - BRAZIL

Introdução

Older adults are at increased risk for infectious diseases, due to weaker immune systems, and chronic diseases. There are approximately 250,000 adults aged ≥ 60 years in Curitiba, the largest city in Brazil’s South region, representing 13% of the total population. The objective of this study was to evaluate the burden of pneumococcal disease hospitalizations among adults aged ≥ 60 years in Curitiba city from the public healthcare perspective.

Material e Método

A retrospective analysis of Curitiba city public hospital admissions for pneumococcal disease was developed according to ICD-10 classification (pneumonia: J13, J15 to J18; invasive pneumococcal disease [IPD]: G.001, A40.3, and B95.3) in adults aged ≥ 60 years, as reported in Brazilian Hospital Information System (SIH/DATASUS) database from January 2014 to December 2017. Data were stratified by age (60-64y, 65-69y, 70-74y, 75-79y and 80y+), year of the analysis, and ICD-10 (pneumonia and IPD).

Resultados

In this population, hospital admissions were 4,559 in the period. Of these, the largest part (4,548; 99.8%) was due to pneumonia. Hospital admissions were 1327, 1120, 1020 and 1092 in 2014, 2015, 2016 and 2017, respectively, and deaths were 282, 217, 233 and 247 for the same period. Mean length of stay was 8 days for the analyzed period. The total admissions cost for the entire period was 6,150,793 BRL, being 1,744,470 BRL, 1,433,599 BRL, 1,460,074 BRL and 1,512,649 BRL in 2014, 2015, 2016 and 2017, respectively. Mean cost per admission for all years was 1349.15 BRL. Despite the high number of admissions due to pneumonia, the mean cost per admission for this disease was four times lower than the cost of treating IPD (1339.07 BRL versus 5,519.43 BRL).

Discussão e Conclusões

In Brazil, only adults with chronic diseases and immunosuppression conditions have access to publicly-funded pneumococcal immunization programs. The major medical societies in Brazil as well as the United States Centers for Disease Control and Prevention recommend vaccination against pneumococcal diseases for adults aged ≥ 60 years. This analysis showed that costs for these hospitalizations were substantial in Curitiba suggesting that routine older age extension of publicly-funded pneumococcal immunization programs could provide a reduction in the burden of pneumococcal disease.

Palavras Chave

Pneumococcal disease, Pneumonia