tetano
Editor, Senior Moderator
BMC Infect Dis
. 2024 Jun 8;24(1):572.
doi: 10.1186/s12879-024-09446-2. The Hospital Burden of Flu in Italy: a retrospective study on administrative data from season 2014-2015 to 2018-2019
Riccardo Cipelli[SUP] 1 [/SUP], Serena Falato[SUP] 2 [/SUP], Eleonora Lusito[SUP] 2 [/SUP], Giovanni Maifredi[SUP] 3 [/SUP], Michele Montedoro[SUP] 4 [/SUP], Paola Valpondi[SUP] 5 [/SUP], Alberto Zucchi[SUP] 6 [/SUP], Maria Vittoria Azzi[SUP] 7 [/SUP], Laura Zanetta[SUP] 7 [/SUP], Maria Rosaria Gualano[SUP] 8 [/SUP], Entela Xoxi[SUP] 9 [/SUP], Paola Giovanna Marchisio[SUP] #[/SUP][SUP] 10 11 [/SUP], Silvana Castaldi[SUP] #[/SUP][SUP] 12 11 [/SUP]
Affiliations
Background: Every year in Italy, influenza affects about 4 million people. Almost 5% of them are hospitalised. During peak illness, enormous pressure is placed on healthcare and economic systems. This study aims to quantify the clinical and economic burden of severe influenza during 5 epidemic seasons (2014-2019) from administrative claims data.
Methods: Patients hospitalized with a diagnosis of influenza between October 2014, and April 2019, were analyzed. Clinical characteristics and administrative information were retrieved from health-related Administrative Databases (ADs) of 4 Italian Local Health Units (LHUs). The date of first admission was set as the Index Date (ID). A follow-up period of six months after ID was considered to account for complications and re-hospitalizations, while a lookback period (2 years before ID) was set to assess the prevalence of underlying comorbidities.
Results: Out of 2,333 patients with severe influenza, 44.1% were adults ≥ 65, and 25.6% young individuals aged 0-17. 46.8% had comorbidities (i.e., were at risk), mainly cardiovascular and metabolic diseases (45.3%), and chronic conditions (24.7%). The highest hospitalization rates were among the elderly (≥ 75) and the young individuals (0-17), and were 37.6 and 19.5/100,000 inhabitants/year, respectively. The average hospital stay was 8 days (IQR: 14 - 4). It was higher for older individuals (≥ 65 years, 11 days, [17 - 6]) and for those with comorbidities (9 days, [16 - 6]), p-value < 0.001. Similarly, mortality was higher in elderly and those at risk (p-value < 0.001). Respiratory complications occurred in 12.7% of patients, and cardiovascular disorders in 5.9%. Total influenza-related costs were €9.7 million with hospitalization accounting for 95% of them. 47.3% of hospitalization costs were associated with individuals ≥ 65 and 52.9% with patients at risk. The average hospitalisation cost per patient was € 4,007.
Conclusions: This retrospective study showed that during the 2014-2019 influenza seasons in Italy, individuals of extreme ages and those with pre-existing medical conditions, were more likely to be hospitalized with severe influenza. Together with complications and ageing, they worsen patient's outcome and may lead to a prolonged hospitalization, thus increasing healthcare utilization and costs. Our data generate real-world evidence on the burden of influenza, useful to inform public health decision-making.
Keywords: Administrative database; Burden; Comorbidities; Complications; Costs; Hospitalization; Influenza; Local health units; Secondary health care.
. 2024 Jun 8;24(1):572.
doi: 10.1186/s12879-024-09446-2. The Hospital Burden of Flu in Italy: a retrospective study on administrative data from season 2014-2015 to 2018-2019
Riccardo Cipelli[SUP] 1 [/SUP], Serena Falato[SUP] 2 [/SUP], Eleonora Lusito[SUP] 2 [/SUP], Giovanni Maifredi[SUP] 3 [/SUP], Michele Montedoro[SUP] 4 [/SUP], Paola Valpondi[SUP] 5 [/SUP], Alberto Zucchi[SUP] 6 [/SUP], Maria Vittoria Azzi[SUP] 7 [/SUP], Laura Zanetta[SUP] 7 [/SUP], Maria Rosaria Gualano[SUP] 8 [/SUP], Entela Xoxi[SUP] 9 [/SUP], Paola Giovanna Marchisio[SUP] #[/SUP][SUP] 10 11 [/SUP], Silvana Castaldi[SUP] #[/SUP][SUP] 12 11 [/SUP]
Affiliations
- PMID: 38851739
- PMCID: PMC11162570
- DOI: 10.1186/s12879-024-09446-2
Background: Every year in Italy, influenza affects about 4 million people. Almost 5% of them are hospitalised. During peak illness, enormous pressure is placed on healthcare and economic systems. This study aims to quantify the clinical and economic burden of severe influenza during 5 epidemic seasons (2014-2019) from administrative claims data.
Methods: Patients hospitalized with a diagnosis of influenza between October 2014, and April 2019, were analyzed. Clinical characteristics and administrative information were retrieved from health-related Administrative Databases (ADs) of 4 Italian Local Health Units (LHUs). The date of first admission was set as the Index Date (ID). A follow-up period of six months after ID was considered to account for complications and re-hospitalizations, while a lookback period (2 years before ID) was set to assess the prevalence of underlying comorbidities.
Results: Out of 2,333 patients with severe influenza, 44.1% were adults ≥ 65, and 25.6% young individuals aged 0-17. 46.8% had comorbidities (i.e., were at risk), mainly cardiovascular and metabolic diseases (45.3%), and chronic conditions (24.7%). The highest hospitalization rates were among the elderly (≥ 75) and the young individuals (0-17), and were 37.6 and 19.5/100,000 inhabitants/year, respectively. The average hospital stay was 8 days (IQR: 14 - 4). It was higher for older individuals (≥ 65 years, 11 days, [17 - 6]) and for those with comorbidities (9 days, [16 - 6]), p-value < 0.001. Similarly, mortality was higher in elderly and those at risk (p-value < 0.001). Respiratory complications occurred in 12.7% of patients, and cardiovascular disorders in 5.9%. Total influenza-related costs were €9.7 million with hospitalization accounting for 95% of them. 47.3% of hospitalization costs were associated with individuals ≥ 65 and 52.9% with patients at risk. The average hospitalisation cost per patient was € 4,007.
Conclusions: This retrospective study showed that during the 2014-2019 influenza seasons in Italy, individuals of extreme ages and those with pre-existing medical conditions, were more likely to be hospitalized with severe influenza. Together with complications and ageing, they worsen patient's outcome and may lead to a prolonged hospitalization, thus increasing healthcare utilization and costs. Our data generate real-world evidence on the burden of influenza, useful to inform public health decision-making.
Keywords: Administrative database; Burden; Comorbidities; Complications; Costs; Hospitalization; Influenza; Local health units; Secondary health care.