Disease and economic burden of infections in hospitalised children in New South Wales, Australia
Brendan J. McMullan
A B C * , Jake C. Valentine C D , Lisa Hall C E and Karin Thursky C D F
A School of Women’s and Children’s Health, UNSW Sydney, Sydney, NSW, Australia.
B Department of Immunology and Infectious Diseases, Sydney Children’s Hospital, Randwick, Sydney, NSW, Australia.
C National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Melbourne, Vic., Australia.
D Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Vic., Australia.
E School of Public Health, University of Queensland, Brisbane, Qld, Australia.
F National Centre for Antimicrobial Stewardship, Peter Doherty Institute, Melbourne, Vic., Australia.
Australian Health Review 46(4) 471-477 https://doi.org/10.1071/AH21360
Submitted: 24 November 2021 Accepted: 10 May 2022 Published: 7 June 2022
© 2022 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.
Abstract
Objectives To describe the burden of disease and hospitalisation costs in children with common infections using statewide administrative data.
Methods We analysed hospitalisation prevalence and costs for 10 infections: appendicitis, cellulitis, cervical lymphadenitis, meningitis, osteomyelitis, pneumonia, pyelonephritis, sepsis, septic arthritis, and urinary tract infections in children aged <18 years admitted to hospital within New South Wales, Australia, using an activity-based management administrative dataset over three financial years (1 July 2016–30 June 2019).
Results Among 339 077 admissions, 28 748 (8.48%) were coded with one of the 10 infections, associated with a total hospitalisation cost of AUD230 905 190 and a per episode median length-of-stay of 3 bed-days. Pneumonia was the most prevalent coded infection (3.1% [n = 10 524] of all admissions), followed by appendicitis (1.61%; n = 5460), cellulitis (1.22%; n = 4126) and urinary tract infections (0.94%; n = 3193). Eighty per cent of children (n = 22 529) were admitted to a non-paediatric hospital. Mean costs were increased 1.18-fold per additional bed-day, 2.14-fold with paediatric hospital admissions, and 5.49-fold with intensive care unit admissions, which were both also associated with greater total bed-day occupancy. Indigenous children comprised 9.7% of children admitted with these infections, and mean per episode costs, and median bed-days were reduced compared with non-Indigenous children (0.84 [95% CI 0.78, 0.89] and 3 (IQR: 2,5) vs 2 (IQR: 2,4), respectively.
Conclusions Infections in children requiring hospitalisation contribute a substantial burden of disease and cost to the community. This varies by infection, facility type, and patient demographics, and this information should be used to inform and prioritise programs to improve care for children.
Keywords: activity based management, Australia, child, costs, economics, epidemiology, hospital, infections.
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