A Study of Influenza and Influenza-Related Complications among Children in a Large US Health Insurance Plan Database
- 91 Downloads
Background: Influenza places a substantial burden on the affected individual and society. While there are data available on the overall occurrence of influenza in children, less information is available on the differential impact of influenza on healthcare for previously healthy children and those at high risk of developing influenza-related complications.
Objective: To compare the frequency of influenza-related complications in healthy and ‘at-risk’ children, and quantify the associated use of medical resources and costs.
Design: Data were obtained from a large US-based health insurance plan database.
Main outcome measures and results: A total of 23 188 health insurance claims with an influenza diagnosis were identified over the 3-year period 1995–1997 (3 247 834 patient-years). Influenza-related complications were observed in approximately a quarter of the total diagnosed cases, with younger children (0–4 years of age) at substantially greater risk. ‘At-risk’ children were more likely to develop influenza-related complications than otherwise healthy children. The greatest difference in incidence rate in the 0–4 year age group was for asthma (incidence rate ratio 8.7, 95% CI 5.2–14.4), and in the 5–14 year age group for asthma (incidence rate ratio 8.5, 95% CI 5.2–13.7) and acute sinusitis (incidence rate ratio 2.7, 95% CI 1.2–5.4). The average direct medical costs of influenza in children under 15 years with complications were more than 3.5 times higher than those without.
Conclusions: Measures to prevent and treat influenza-related complications are certainly warranted for at-risk children, although the elevated incidence rates for several common complications even among healthy children should prompt consideration of these measures for all children.
KeywordsInfluenza Acute Otitis Medium Oseltamivir Medical Resource Zanamivir
This study was financially supported by F. Hoffmann-La Roche Ltd. Nick Poulios, Pavel Napalkov and Yann Wegmüller are employees of F. Hoffmann-La Roche Ltd. Dr Monto is a consultant to Hoffmann-La Roche Ltd. The authors gratefully acknowledge the assistance of Clorinda Cali, Lisa Weatherby and the staff of the Epidemiology Division of Ingenix for their contributions to the analysis of the claims data.
- 3.Sullivan KM, Monto AS, Longini IM. Estimates of the US health impact of influenza. Am J Public Health 1993; 155: 1119–26Google Scholar
- 4.Kavet JA. Perspectives on the significance of pandemic influenza. Am J Epidemiol 1997; 127: 353–64Google Scholar
- 9.Centers for Disease Control. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 1999; 48 (RR-4): 1–28Google Scholar
- 11.National Center for Health Statistics. Current estimates from the National Health Interview Survey, 1994. Vital and health statistics. Series 10, no. 193. DHHS publication no. PHS 96-1521. Washington (DC): Government Printing Office, 1995Google Scholar
- 16.Health care financing administration common procedure coding system (HCPCS). Salt Lake City (UT): Medicode, 1999Google Scholar
- 17.Current procedural terminology (CPT). Chicago (IL): American Medical Association, 1999Google Scholar
- 18.SAS Institute Inc. SAS/STAT User’s Guide, release 6.12th ed. Cary (NC): SAS Institute Inc, 1997Google Scholar
- 19.Treanor JJ, Hall CB. Influenza and infections of the trachea, bronchi, and bronchioles. In: Reese RE, Betts RF, editors. A practical approach to infectious diseases. 4th ed. New York: Little Brown, 1996: 240–57Google Scholar
- 26.McEvoy GK, editor. American hospital formulary service. Bethesda (MD): American Society of Health-System Pharmacists, 2000Google Scholar
- 29.Centers for Disease Control. Prevention and control of influenza. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep 2002; 51 (RR-3): 1–34Google Scholar