Hospital costs of, and factors contributing to, a pertussis epidemic

Abstract

Pertussis (whooping cough), a vaccine-preventable and highly infectious respiratory tract disease, caused a major epidemic in Australia during 1997, resulting in large numbers of babies and children being hospitalised. This retrospective study was designed to calculate the costs of this epidemic to a 250-bed paediatric teaching hospital in Western Australia (WA) and discuss the factors contributing to the epidemic. In all, 92 babies and children required 115 hospital admissions for pertussis. Thirteen were admitted to the paediatric or neonatal intensive care unit (P/NICU) at a cost of $229,500 and the 113 ward admissions cost $504,500. In addition, the microbiology diagnostic testing was estimated to cost $200,000. Thus, the real cost to the hospital over the 12-month period was $934,000. The majority of the patients were aged between 2 and 6 months, while all those requiring P/NICU admission were less than 6 months old. The younger the patient the greater the length of stay (average 6.6 days). A comparison was made between patient age, incidence of hospital admission, length of stay and P/NICU admission. When the immunisation compliance rate of inpatients with pertussis was assessed, only 45 per cent of all those aged more than 2 months were up to date with their pertussis immunisation regime and, for 17 per cent, their immunisation status in the medical records was either lacking or poorly written. This study highlighted the need to improve pertussis immunisation compliance by educating both parents and health professionals regarding expected reactions to, and true contraindications for, pertussis vaccination, as well as for health-care professionals to improve immunisation documentation in the hospital's medical records.