Direct Medical Cost Analysis of Dengue Patients: A Retrospective Study
Downloads
Background: Dengue infection is an arboviral disease that could lead to severe illness. The incidence of severe dengue will impact patients' financial aspects. As an important clinical feature, platelet level on admission day might contribute to the direct medical cost. Objective: This study aimed to examine the direct medical cost among patients with dengue fever (DF) or dengue hemorrhagic fever (DHF) in Yogyakarta, Indonesia. Methods: This study was a retrospective study conducted in two private hospitals in Yogyakarta, Indonesia. Participants included in this study were hospitalized patients diagnosed with DF or DHF. Data were extracted from medical records and finance departments in each hospital. Results: Among 174 dengue patients included in this study, the mean age of DHF patients (18.44 + 14.87) was lower than in DF patients (23.47 + 18.99). Patients with DHF (4.88 days) also showed prolonged hospitalization compared with DF (4.18 days) patients. In terms of medical cost, DHF patients need a higher dengue treatment cost, which is about 329.74 USD compared to 220.68 USD for DF patients in hospital 2. Mainly related to room charges, which increased by 9.48% in hospital 1 and 66.28% in hospital 2 compared with DF patients. Furthermore, DHF patients with thrombocytopenia on the first day of admission present higher medical costs in terms of laboratory fees (36.08%), medicine (18.17%), and total medical costs (9.84%). Conclusion: Severe form of dengue will contribute to economic burden. Therefore, prevention and adequate treatment are essential to reduce the prognosis of severe dengue and higher medical cost.
Azeredo, E. L. De, Monteiro, R. Q., and Pinto, L. M. (2015). Thrombocytopenia in Dengue : Interrelationship between Virus and the Imbalance between Coagulation and Fibrinolysis and Inflammatory Mediators. Mediators of Inflammation, 2015, 1-17. https://doi.org/10.1155/2015/313842.
Bajwala, V. R., John, D., Rajasekar, T. D., and Murhekar, M. V. (2019). Severity and costs associated with hospitalization for dengue in public and private hospitals of Surat city, Gujarat, India, 2017-2018. Transactions of the Royal Society of Tropical Medicine and Hygiene, 113(11), 661–669. https://doi.org/10.1093/trstmh/trz057.
Burattini, M. N., Lopez, L. F., Coutinho, I. I. I. F. A. B., and Joa, I. (2016). Age and regional differences in clinical presentation and risk of hospitalization for dengue in Brazil , 2000-2014. Clinics, 71(8), 455–463. https://doi.org/10.6061/clinics/2016(08)08.
Castilho, B. M., Silva, M. T., Freitas, A. R. R., Fulone, I., and Lopes, L. C. (2020). Factors associated with thrombocytopenia in patients with dengue fever: a retrospective cohort study. BMJ Open, 10(9), e035120. https://doi.org/10.1136/bmjopen-2019-035120.
Elson, W. H., Riley-powell, A. R., Morrison, A. C., Gotlieb, E. E., Groessl, J., Cordova, J. J., Rios, J. E., Quiroz, W. L., Vizcarra, A. S., Reiner, R. C., Id, C. M. B., Vazquez-prokopec, G. M., Id, W. S., Id, A. L. R., Elder, J. P., and Paz-soldan, V. A. (2020). Measuring health related quality of life for dengue patients in Iquitos , Peru. PLoS Neglected Tropical Disease, 14(7), 1–17. https://doi.org/10.1371/journal.pntd.0008477.
Faridah, I. N., Dania, H., Chen, Y.-H., Supadmi, W., Purwanto, B. D., Heriyanto, M. J., Aufa, M. A., Chang, W.-C., and Perwitasari, D. A. (2022). Dynamic Changes of Platelet and Factors Related Dengue Haemorrhagic Fever: A Retrospective Study in Indonesian. In Diagnostics (Vol. 12, Issue 4). https://doi.org/10.3390/diagnostics12040950.
Harapan, H., Michie, A., Mudatsir, M., Sasmono, R. T., and Imrie, A. (2019). Epidemiology of dengue hemorrhagic fever in Indonesia: Analysis of five decades data from the National Disease Surveillance. BMC Research Notes, 12(1), 4–9. https://doi.org/10.1186/s13104-019-4379-9.
Hegazi, M. A., Bakarman, M. A., Alahmadi, T. S., Butt, N. S., Alqahtani, A. M., Aljedaani, B. S., and Almajnuni, A. H. (2020). Risk Factors and Predictors of Severe Dengue in Saudi Population in Jeddah, Western Saudi Arabia: A Retrospective Study. The American Journal of Tropical Medicine and Hygiene, 102(3), 613–621. https://doi.org/10.4269/ajtmh.19-0650.
Hsieh, C., Cia, C., Lee, J., Sung, J., Lee, N., Chen, L., Kuo, T., Chao, J., and Ko, W. (2017). A Cohort Study of Adult Patients with Severe Dengue in Taiwanese Intensive Care Units : The Elderly and APTT Prolongation Matter for Prognosis. PLoS Neglected Tropical Diseases, 11(1), 1–14. https://doi.org/10.1371/journal.pntd.0005270.
Jayarajah, U., Madarasinghe, M., Hapugoda, D., Dissanayake, U., Perera, L., Kannangara, V., Udayangani, C., Peiris, R., Yasawardene, P., Zoysa, I. De, and Seneviratne, S. L. (2020). Clinical and Biochemical Characteristics of Dengue Infections in Children From Sri Lanka. https://doi.org/10.1177/2333794X20974207.
Jiang, L., Liu, Y., Su, W., Liu, W., and Yang, Z. (2021). Decreased dengue cases attributable to the effect of COVID-19 in Guangzhou in 2020. PLOS Neglected Tropical Diseases, 15(5), e0009441. https://doi.org/10.1371/journal.pntd.0009441.
Khan, E., Prakoso, D., Imtiaz, K., Malik, F., Farooqi, J. Q., Long, M. T., and Barr, K. L. (2020). The Clinical Features of Co-circulating Dengue Viruses and the Absence of Dengue Hemorrhagic Fever in Pakistan. Frontiers in Public Health, 8, 287. https://doi.org/10.3389/fpubh.2020.00287.
Lam, P. K., Ngoc, T. Van, Thu Thuy, T. T., Hong Van, N. T., Nhu Thuy, T. T., Hoai Tam, D. T., Dung, N. M., Hanh Tien, N. T., Thanh Kieu, N. T., Simmons, C., Wills, B., and Wolbers, M. (2017). The value of daily platelet counts for predicting dengue shock syndrome: Results from a prospective observational study of 2301 Vietnamese children with dengue. PLoS Neglected Tropical Diseases, 11(4), e0005498. https://doi.org/10.1371/journal.pntd.0005498.
Lim, J. T., Chew, L. Z. X., Choo, E. L. W., Dickens, B. S. L., Ong, J., Aik, J., Ng, L. C., and Cook, A. R. (2021). Increased Dengue Transmissions in Singapore Attributable to SARS-CoV-2 Social Distancing Measures. The Journal of Infectious Diseases, 223(3), 399–402. https://doi.org/10.1093/infdis/jiaa619.
Liyanage, P., Rocklöv, J., and Tissera, H. A. (2021). The impact of COVID–19 lockdown on dengue transmission in Sri Lanka; A natural experiment for understanding the influence of human mobility. PLOS Neglected Tropical Diseases, 15(6), e0009420. https://doi.org/10.1371/journal.pntd.0009420.
Luh, D.-L., Liu, C.-C., Luo, Y.-R., and Chen, S.-C. (2018). Economic cost and burden of dengue during epidemics and non-epidemic years in Taiwan. Journal of Infection and Public Health, 11(2), 215–223. https://doi.org/10.1016/j.jiph.2017.07.021.
Mallhi, T. H., Khan, A. H., Sarriff, A., Adnan, A. S., and Khan, Y. H. (2017). Determinants of mortality and prolonged hospital stay among dengue patients attending tertiary care hospital: a cross-sectional retrospective analysis. BMJ Open, 7(7), e016805. https://doi.org/10.1136/bmjopen-2017-016805.
Ministry of Health Republic of Indonesia. (2021). National strategy for dengue control 2021-2025. Jakarta : Ministry of Health RI 2021.
Nujum, Z. T., Beegum, M. S., Meenakshy, V., and Vijayakumar, K. (2020). Cost analysis of dengue from a State in south India. The Indian Journal of Medical Research, 152(5), 490–497. https://doi.org/10.4103/ijmr.IJMR_1641_18.
Oliveira, L. N. da S., Itria, A., and Lima, E. C. (2019). Cost of illness and program of dengue: A systematic review. PloS One, 14(2), e0211401. https://doi.org/10.1371/journal.pone.0211401.
Pang, J., Hsu, J. P., Yeo, T. W., Leo, Y. S., and Lye, D. C. (2017). Diabetes , cardiac disorders and asthma as risk factors for severe organ involvement among adult dengue patients : A matched case-control study. Nature Scientific Reports, 7(39872), 1–10. https://doi.org/10.1038/srep39872.
Panmei, K., Joseph, A. K., Rose, W., Abraham, O. C., Mathuram, A. J., Kumar, S., and Abraham, A. M. (2019). Direct cost of illness for dengue in hospitalized children and adults at a referral hospital in India. International Journal of Infectious Diseases, 84S, S64–S67. https://doi.org/10.1016/j.ijid.2019.02.033.
Plasencia-Dueñas, R., Failoc-Rojas, V. E., and Rodriguez-Morales, A. J. (2022). Impact of the COVID-19 pandemic on the incidence of dengue fever in Peru. Journal of Medical Virology, 94(1), 393–398. https://doi.org/10.1002/jmv.27298
Pourhoseingholi, M. A., Vahedi, M., and Rahimzadeh, M. (2013). Sample size calculation in medical studies. Gastroenterology and Hepatology from Bed to Bench, 6(1), 14–17. https://pubmed.ncbi.nlm.nih.gov/24834239.
Rafikahmed, S. R., Mateti, U. V., Subramanya, C., Shetty, S., Sunny, A., and Madhusoodanan, A. (2021). Assessment of direct medical cost using cost of illness analysis in patients with dengue fever - Retrospective study. Clinical Epidemiology and Global Health, 12, 100842. https://doi.org/https://doi.org/10.1016/j.cegh.2021.100842.
Shepard, D. S., Undurraga, E. A., Halasa, Y. A., and Stanaway, J. D. (2016). The global economic burden of dengue: a systematic analysis. The Lancet. Infectious Diseases, 16(8), 935–941. https://doi.org/10.1016/S1473-3099(16)00146-8
Stahl, H.-C., Butenschoen, V. M., Tran, H. T., Gozzer, E., Skewes, R., Mahendradhata, Y., Runge-Ranzinger, S., Kroeger, A., and Farlow, A. (2013). Cost of dengue outbreaks: literature review and country case studies. BMC Public Health, 13, 1048. https://doi.org/10.1186/1471-2458-13-1048.
Supadmi, W., Izzah, Q., Suwantika, A., Perwitasari, D., and Abdulah, R. (2019). Cost of Illness Study of Patients with Dengue Hemorrhagic Fever at One of the Private Hospitals in Yogyakarta. Journal of Pharmacy And Bioallied Sciences, 11(8), 587–593. https://doi.org/10.4103/jpbs.JPBS_214_19.
Thein, T., Leo, Y., Fisher, D. A., Low, J. G., Oh, H. M. L., Gan, V. C., Wong, J. G. X., and Lye, D. C. (2013). Risk Factors for Fatality among Confirmed Adult Dengue Inpatients in Singapore : A Matched Case-Control Study. PLoS ONE, 8(11), 1–6. https://doi.org/10.1371/journal.pone.0081060
Vieira Machado, A. A., Estevan, A. O., Sales, A.., Brabes, K. C. da S., Croda, J., and Negrí£o, F. J. (2014). Direct Costs of Dengue Hospitalization in Brazil: Public and Private Health Care Systems and Use of WHO Guidelines. PLOS Neglected Tropical Diseases, 8(9), e3104. https://doi.org/10.1371/journal.pntd.0003104.
Wilastonegoro, N. N., Kharisma, D. D., Laksono, I. S., Halasa-Rappel, Y. A., Brady, O. J., and Shepard, D. S. (2020). Cost of Dengue Illness in Indonesia across Hospital, Ambulatory, and not Medically Attended Settings. The American Journal of Tropical Medicine and Hygiene, 103(5), 2029–2039. https://doi.org/10.4269/ajtmh.19-0855
Wilder-smith, A., Ooi, E., Horstick, O., and Wills, B. (2019). Dengue. Lancet, 393, 350–363. https://doi.org/10.1016/S0140-6736(18)32560-1.
World Health Organization. (1997). Dengue haemorrhagic fever : Diagnosis, treatment, prevention and control. Second Edition. World HealthOrganization. https://apps.who.int/iris/handle/10665/41988. Accessed : 7 January 2022.
World Health Organization. (2022). Dengue and severe dengue. 2022. https://www.who.int/news-room/fact-sheets/detail/dengue-and-severe-dengue. Accessed : 7 January 2022.
Zeng, Z., Zhan, J., Chen, L., Chen, H., and Cheng, S. (2021). Global , regional , and national dengue burden from 1990 to 2017 : A systematic analysis based on the global burden of disease study 2017. EClinicalMedicine, 32, 100712. https://doi.org/10.1016/j.eclinm.2020.100712.
Copyright (c) 2022 JURNAL FARMASI DAN ILMU KEFARMASIAN INDONESIA
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
1. The copyright of this journal belongs to the Editorial Board and Journal Manager with the author's knowledge, while the moral right of the publication belong to the author.
2. The formal legal aspect of journal publication accessibility refers to the Creative Commons Attribution-Non-Commercial-Share Alike (CC BY-NC-SA), which implies that the publication can be used for non-commercial purposes in its original form.
3. Every publication (print/electronic) is open access for educational, research, and library purposes. In addition to the objectives mentioned above, the editorial board is not responsible for copyright infringement