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Varicella healthcare resource utilization in middle income countries: a pooled analysis of the multi-country MARVEL study in Latin America & Europe

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dc.contributor.author Wolfson, Lara J.
dc.contributor.author Castillo, Maria Esther
dc.contributor.author Giglio, Norberto
dc.contributor.author Meszner, Zsofia
dc.contributor.author Molnar, Zsuzsanna
dc.contributor.author Vazquez, Mirella
dc.contributor.author Wysocki, Jacek
dc.contributor.author Altland, Alexandra
dc.contributor.author Kuter, Barbara J.
dc.contributor.author Rickard, Jenaya
dc.contributor.author Rampakakis, Emmanouil
dc.date.accessioned 2019-12-06T20:57:49Z
dc.date.available 2019-12-06T20:57:49Z
dc.date.issued 2019
dc.identifier.uri https://hdl.handle.net/20.500.12866/7428
dc.description.abstract Varicella is a mild and self-limited illness in children, but can result in significant healthcare resource utilization (HCRU). To quantify/contrast varicella-associated HCRU in five middle-income countries (Hungary, Poland, Argentina, Mexico, and Peru) where universal varicella vaccination was unimplemented, charts were retrospectively reviewed among 1–14 year-olds. Data were obtained on management of primary varicella between 2009–2016, including outpatient/inpatient visits, allied healthcare contacts, tests/procedures, and medications. These results are contrasted across countries, and a regression model is fit to extrapolated country-level costs as a function of gross domestic product (GDP). A total of 401 outpatients and 386 inpatients were included. Significant differences between countries were observed in the number of skin lesions among outpatients, ranging from 5.3% to 25.4% of patients with ≥250 lesions. Among inpatients, results were less variable. Average ambulatory medical visits ranged from 1.1 to 2.2. Average hospital stay ranged from 3.6 to 6.8 days. Use of tests/procedures was infrequent in outpatients, except in Argentina (13.3%); among inpatients, a test/procedure was ordered for 81.3% of patients, without regional variation. Prescription medications were administered in 44.4% of outpatients (range 9.3%–80.0%), and in 86% of inpatients (range 70.4%–94.9%). Total estimated spending on varicella treatment in the absence of vaccination was predicted from income levels (GDP) with an exponential function (R 2  = 0.89). This study demonstrates that substantial HCRU is associated with varicella resulting in significant public health burden that could be alleviated through the use of varicella vaccination. Differences observed between countries possibly reflect treatment guidelines, healthcare resource availabilities and physician practices. en_US
dc.language.iso eng
dc.publisher Taylor & Francis
dc.relation.ispartof urn:issn:2164-554X
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject adolescent en_US
dc.subject Argentina en_US
dc.subject Article en_US
dc.subject chickenpox en_US
dc.subject chickenpox vaccine en_US
dc.subject child en_US
dc.subject costs en_US
dc.subject Europe en_US
dc.subject female en_US
dc.subject general practitioner en_US
dc.subject gross national product en_US
dc.subject health care utilization en_US
dc.subject healthcare resource utilization (HCRU) en_US
dc.subject hospitalization en_US
dc.subject human en_US
dc.subject Hungary en_US
dc.subject intensive care unit en_US
dc.subject major clinical study en_US
dc.subject male en_US
dc.subject middle income country en_US
dc.subject multi-country en_US
dc.subject observational study en_US
dc.subject pediatrics en_US
dc.subject post hoc analysis en_US
dc.subject regression analysis en_US
dc.subject retrospective study en_US
dc.subject skin defect en_US
dc.subject South and Central America en_US
dc.subject vaccination en_US
dc.subject varicella en_US
dc.title Varicella healthcare resource utilization in middle income countries: a pooled analysis of the multi-country MARVEL study in Latin America & Europe en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1080/21645515.2018.1559687
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.01.03


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