Excess influenza hospital admissions and costs due to the 2009 H1N1 pandemic in England
File(s)
Published version
Author(s)
Miraldo, M
Lau, Krystal
Hauck, Katharina
Type
Journal Article
Abstract
Influenza pandemics considerably burden affected health systems due to surges in inpatient admissions and associated costs. Previous studies underestimate or overestimate 2009/2010 influenza A/H1N1 pandemic hospital admissions and costs. We robustly estimate overall and age‐specific weekly H1N1 admissions and costs between June 2009 and March 2011 across 170 English hospitals. We calculate H1N1 admissions and costs as the difference between our administrative data of all influenza‐like‐illness patients (seasonal and pandemic alike) and a counterfactual of expected weekly seasonal influenza admissions and costs established using time‐series models on prepandemic (2004–2008) data.
We find two waves of H1N1 admissions: one pandemic wave (June 2009–March 2010) with 10,348 admissions costing £20.5 million and one postpandemic wave (November 2010–March 2011) with 11,775 admissions costing £24.8 million. Patients aged 0–4 years old have the highest H1N1 admission rate, and 25‐ to 44‐ and 65+‐year‐olds have the highest costs. Our estimates are up to 4.3 times higher than previous reports, suggesting that the pandemic's burden on hospitals was formerly underassessed. Our findings can help hospitals manage unexpected surges in admissions and resource use due to pandemics.
We find two waves of H1N1 admissions: one pandemic wave (June 2009–March 2010) with 10,348 admissions costing £20.5 million and one postpandemic wave (November 2010–March 2011) with 11,775 admissions costing £24.8 million. Patients aged 0–4 years old have the highest H1N1 admission rate, and 25‐ to 44‐ and 65+‐year‐olds have the highest costs. Our estimates are up to 4.3 times higher than previous reports, suggesting that the pandemic's burden on hospitals was formerly underassessed. Our findings can help hospitals manage unexpected surges in admissions and resource use due to pandemics.
Date Issued
2019-02-01
Date Acceptance
2018-09-03
Citation
Health Economics, 2019, 28 (2), pp.175-188
ISSN
1057-9230
Publisher
Wiley
Start Page
175
End Page
188
Journal / Book Title
Health Economics
Volume
28
Issue
2
Copyright Statement
© 2018 The Authors. Health Economics published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
© 2018 The Authors. Health Economics published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Sponsor
National Institute for Health Research
Pepfar, NIAID, NIMH, NIDA, BMGF
Department for International Development (UK) (DFI
Medical Research Council (MRC)
Grant Number
HPRU-2012-10080
N/A
MR/R015600/1
Subjects
Social Sciences
Science & Technology
Life Sciences & Biomedicine
Economics
Health Care Sciences & Services
Health Policy & Services
Business & Economics
cost
H1N1 pandemic
hospital admissions
SARIMA
time series
RESPIRATORY SYNCYTIAL VIRUS
A H1N1
INFECTION
CHILDREN
BURDEN
14 Economics
11 Medical And Health Sciences
Publication Status
Published
Date Publish Online
2018-10-18