Economic burden of pertussis in children: A single-center analysis in Hangzhou, China

ABSTRACT

The “reemergence of pertussis” has elicited international concerns, occurring paradoxically amidst the expansion of immunization programs. This study was aimed to evaluate quantitatively the economic burden and identify the determinants that influence the cost associated with treating pertussis in Chinese children. We evaluated the economic burden by Chinese children diagnosed with pertussis at the Children’s Hospital, Zhejiang University School of Medicine in 2022. Direct medical expenses and the utilization of medical resources attributed to pertussis were calculated. A generalized linear regression model was applied to analyze the determinants that were associated with the direct medical expenses among patients. Among the 1110 pertussis patients included in the study, 1060 were outpatients and 50 were inpatients. The average direct medical cost was ¥1878.70(i.e. $279.33). Living in urban areas (OR:1.27, p = .04), complications (OR:1.40, p < .001), hospitalization (OR:10.04, p < .001), and ≥ 3 medical visits (OR:3.71, p < .001) were associated with increased direct medical expenses. Having received four doses of the pertussis vaccine was associated with reduced direct medical expenses (OR:0.81, p = .04). This study underscores a substantial economic burden of pertussis in Hangzhou, with pronounced implications for patients residing in urban areas, experiencing complications, requiring hospitalization, having multiple medical consultations, or lacking comprehensive pertussis vaccination.

KEYWORDS:

• pertussis
• pertussis vaccination
• factors
• direct medical costs

Disclosure statement

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Author contributions

Yan Liu and Chunzhen Hua: conceptualization. Yingying Yang, Jinsi Zhou and Xuechao Zhang: methodology. Yan Liu, Yingying Yang and Jinsi Zhou: formal analysis, data curation, visualization, writing, review, and editing. Lintao Gu, Yuyang Xu and Zhaojun Lu: investigation. Chunzhen Hua, Xiaoping Zhang and Qixin Xie: resources. Chunzhen Hua and Yan Liu: supervision. Xuechao Zhang: project administration and funding acquisition. All authors contributed to the article and approved the submitted version.

Availability of data and materials

The dataset used in the study are available from the corresponding author on reasonable request.

Ethics approval and consent to participate

The ethics committee of Children’s Hospital, Zhejiang University School of Medicine approved this study protocol and informed consent was obtained from each subject.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This study was supported by Natural Science Foundation of Zhejiang Province, China [LGF18H010001], the Science and Technology Program of Zhejiang Province [2021KY267] and Hangzhou health science and technology plan [A20230202].