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Published on: January 30, 2017
Cost effectiveness of an inpatient influenza immunization assessment and delivery program for children with asthma
Ronald J Teufel1, William T Basco, Kit N Simpson
1Medical University of South Carolina, Charleston, South Carolina 29425, USA. teufelr@musc.edu
Insights
Hospitalized children with asthma are often underimmunized against influenza. Improving vaccination screening in hospitals can significantly increase immunization rates and lead to cost savings.
Area of Science:
- Pediatric Pulmonology
- Public Health
- Health Economics
Background:
- Influenza vaccination rates are low among children with asthma.
- The Centers for Disease Control and Prevention recommends influenza immunization in acute-care settings.
- Hospitalized pediatric asthmatics represent a vulnerable population for influenza.
Purpose of the Study:
- To evaluate the clinical benefits of influenza vaccination for hospitalized children with asthma.
- To determine the potential cost savings associated with increased influenza vaccination rates in this population.
Main Methods:
- Decision analysis and cost-effectiveness analysis were employed.
- A decision tree model simulated influenza vaccination screening interventions.
- Literature review informed assumptions for vaccine status, costs, and outcomes.
Main Results:
- Increased screening rates for influenza vaccine status significantly improved up-to-date (UTD) immunization.
- Screening 20% of hospitalized asthmatics increased UTD status to 35%; 100% screening reached 59%.
- Intervention yielded cost savings of $5.45/child assessed and $9.19/child vaccinated.
Conclusions:
- Implementing influenza vaccination assessment and delivery for hospitalized pediatric asthmatics improves clinical outcomes.
- This intervention is cost-effective, generating significant cost savings.
- Systematic vaccination strategies in hospitals can enhance public health for high-risk pediatric populations.
Background:
Influenza is common in children. Children with asthma are underimmunized. The Centers for Disease Control recommends immunization in an acute-care hospital setting.
Objective:
The purpose of this study was to determine the potential clinical benefit and cost savings of delivering influenza vaccination to hospitalized children with asthma.
Design:
The study was designed as a decision and cost-effectiveness analyses. A decision tree was constructed to represent an intervention to assess and deliver influenza vaccinations to hospitalized pediatric patients with asthma. A literature survey provided estimates for the decision tree assumptions. In the decision analysis, various rates of screening for influenza vaccine status were investigated to determine the effects on final up-to-date (UTD) status in a hypothetical cohort. The cost-effectiveness analysis was used to determine potential cost savings resulting from the modeled increase in UTD status.
Measurements:
The percentage of children ultimately becoming UTD, direct and indirect costs, and cost savings of the intervention were measured.
Results:
With existing data showing that only 29% of asthmatics receive the influenza vaccine in a given year, our decision analysis demonstrated that even modest increases in the screening rate for influenza vaccine status among hospitalized patients with asthma can result in clinically significant increases in UTD status. For example, screening just 20% of those with asthma who are hospitalized would result in 35% ultimately being UTD for that influenza season; and 100% screening would result in 59% being UTD. The cost savings for this intervention would be $5.45/child assessed and $9.19/child vaccinated. Sensitivity analysis demonstrated the results to be robust and generalizable.
Conclusions:
An intervention to improve the assessment and delivery of influenza vaccination to hospitalized pediatric asthmatics would improve clinical outcomes and result in cost savings.
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