IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0169344.html
   My bibliography  Save this article

The Annual Burden of Seasonal Influenza in the US Veterans Affairs Population

Author

Listed:
  • Yinong Young-Xu
  • Robertus van Aalst
  • Ellyn Russo
  • Jason K H Lee
  • Ayman Chit

Abstract

Seasonal influenza epidemics have a substantial public health and economic burden in the United States (US). On average, over 200,000 people are hospitalized and an estimated 23,000 people die from respiratory and circulatory complications associated with seasonal influenza virus infections each year. Annual direct medical costs and indirect productivity costs across the US have been found to average respectively at $10.4 billion and $16.3 billion. The objective of this study was to estimate the economic impact of severe influenza-induced illness on the US Veterans Affairs population. The five-year study period included 2010 through 2014. Influenza-attributed outcomes were estimated with a statistical regression model using observed emergency department (ED) visits, hospitalizations, and deaths from the Veterans Health Administration of the Department of Veterans Affairs (VA) electronic medical records and respiratory viral surveillance data from the Centers for Disease Control and Prevention (CDC). Data from VA’s Managerial Cost Accounting system were used to estimate the costs of the emergency department and hospital visits. Data from the Bureau of Labor Statistics were used to estimate the costs of lost productivity; data on age at death, life expectancy and economic valuations for a statistical life year were used to estimate the costs of a premature death. An estimated 10,674 (95% CI 8,661–12,687) VA ED visits, 2,538 (95% CI 2,112–2,964) VA hospitalizations, 5,522 (95% CI 4,834–6,210) all-cause deaths, and 3,793 (95% CI 3,375–4,211) underlying respiratory or circulatory deaths (inside and outside VA) among adult Veterans were attributable to influenza each year from 2010 through 2014. The annual value of lost productivity amounted to $27 (95% CI $24–31) million and the annual costs for ED visits were $6.2 (95% CI $5.1–7.4) million. Ninety-six percent of VA hospitalizations resulted in either death or a discharge to home, with annual costs totaling $36 (95% CI $30–43) million. The remaining 4% of hospitalizations were followed by extended care at rehabilitation and skilled nursing facilities with annual costs totaling $5.5 (95% CI $4.4–6.8) million. The annual monetary value of quality-adjusted life years (QALYs) lost amounted to $1.1 (95% CI $1.0–1.2) billion. In total, the estimated annual economic burden was $1.2 (95% CI $1.0–1.3) billion, indicating the substantial burden of seasonal influenza epidemics on the US Veterans Affairs population. Premature death was found to be the largest driver of these costs, followed by hospitalization.

Suggested Citation

  • Yinong Young-Xu & Robertus van Aalst & Ellyn Russo & Jason K H Lee & Ayman Chit, 2017. "The Annual Burden of Seasonal Influenza in the US Veterans Affairs Population," PLOS ONE, Public Library of Science, vol. 12(1), pages 1-15, January.
  • Handle: RePEc:plo:pone00:0169344
    DOI: 10.1371/journal.pone.0169344
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0169344
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0169344&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0169344?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Koopmanschap, Marc A. & Rutten, Frans F. H. & van Ineveld, B. Martin & van Roijen, Leona, 1995. "The friction cost method for measuring indirect costs of disease," Journal of Health Economics, Elsevier, vol. 14(2), pages 171-189, June.
    2. Janel Hanmer & William F. Lawrence & John P. Anderson & Robert M. Kaplan & Dennis G. Fryback, 2006. "Report of Nationally Representative Values for the Noninstitutionalized US Adult Population for 7 Health-Related Quality-of-Life Scores," Medical Decision Making, , vol. 26(4), pages 391-400, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Sierk D. Marbus & Valentijn A. Schweitzer & Geert H. Groeneveld & Jan J. Oosterheert & Peter M. Schneeberger & Wim Hoek & Jaap T. Dissel & Arianne B. Gageldonk-Lafeber & Marie-Josée Mangen, 2020. "Incidence and costs of hospitalized adult influenza patients in The Netherlands: a retrospective observational study," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(5), pages 775-785, July.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Rakesh Aggarwal & Qiushi Chen & Amit Goel & Nicole Seguy & Razia Pendse & Turgay Ayer & Jagpreet Chhatwal, 2017. "Cost-effectiveness of hepatitis C treatment using generic direct-acting antivirals available in India," PLOS ONE, Public Library of Science, vol. 12(5), pages 1-15, May.
    2. Iris Arends & Ute Bültmann & Willem van Rhenen & Henk Groen & Jac J L van der Klink, 2013. "Economic Evaluation of a Problem Solving Intervention to Prevent Recurrent Sickness Absence in Workers with Common Mental Disorders," PLOS ONE, Public Library of Science, vol. 8(8), pages 1-1, August.
    3. Simon Wieser & Bruno Horisberger & Sara Schmidhauser & Claudia Eisenring & Urs Brügger & Andreas Ruckstuhl & Jürg Dietrich & Anne Mannion & Achim Elfering & Özgür Tamcan & Urs Müller, 2011. "Cost of low back pain in Switzerland in 2005," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(5), pages 455-467, October.
    4. Anne Tiainen & Clas Rehnberg, 2010. "The Economic Burden of Psychiatric Disorders in Sweden," International Journal of Social Psychiatry, , vol. 56(5), pages 515-526, September.
    5. Chima, Reginald Ikechukwu & Goodman, Catherine A. & Mills, Anne, 2003. "The economic impact of malaria in Africa: a critical review of the evidence," Health Policy, Elsevier, vol. 63(1), pages 17-36, January.
    6. Tilling, C & Krol, M & Tsuchiya, A & Brazier, J & van Exel, J & Brouwer, W, 2009. "The impact of losses in income due to ill health: does the EQ-5D reflect lost earnings?," MPRA Paper 29837, University Library of Munich, Germany.
    7. Luis R Carrasco & Linda K Lee & Vernon J Lee & Eng Eong Ooi & Donald S Shepard & Tun L Thein & Victor Gan & Alex R Cook & David Lye & Lee Ching Ng & Yee Sin Leo, 2011. "Economic Impact of Dengue Illness and the Cost-Effectiveness of Future Vaccination Programs in Singapore," PLOS Neglected Tropical Diseases, Public Library of Science, vol. 5(12), pages 1-9, December.
    8. Hoeijenbos, Margreet & Bekkering, Trudy & Lamers, Leida & Hendriks, Erik & van Tulder, Maurits & Koopmanschap, Marc, 2005. "Cost-effectiveness of an active implementation strategy for the Dutch physiotherapy guideline for low back pain," Health Policy, Elsevier, vol. 75(1), pages 85-98, December.
    9. Beata Gavurova & Miriama Tarhanicova, 2021. "Methods for Estimating Avoidable Costs of Excessive Alcohol Consumption," IJERPH, MDPI, vol. 18(9), pages 1-25, May.
    10. Hanna Gyllensten & Michael Wiberg & Kristina Alexanderson & Anders Norlund & Emilie Friberg & Jan Hillert & Olivia Ernstsson & Petter Tinghög, 2018. "Costs of illness of multiple sclerosis in Sweden: a population-based register study of people of working age," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(3), pages 435-446, April.
    11. Mickaël Hiligsmann & Stuart S. Silverman & Andrea J. Singer & Leny Pearman & Jake Mathew & Yamei Wang & John Caminis & Jean-Yves Reginster, 2023. "Cost-Effectiveness of Sequential Abaloparatide/Alendronate in Men at High Risk of Fractures in the United States," PharmacoEconomics, Springer, vol. 41(7), pages 819-830, July.
    12. Pierre Kopp & Marysia Ogrodnik, 2017. "The social cost of drugs in France in 2010," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(7), pages 883-892, September.
    13. Johan Jarl & Pia Johansson & Antonina Eriksson & Mimmi Eriksson & Ulf-G. Gerdtham & Örjan Hemström & Klara Selin & Leif Lenke & Mats Ramstedt & Robin Room, 2008. "The societal cost of alcohol consumption: an estimation of the economic and human cost including health effects in Sweden, 2002," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 9(4), pages 351-360, November.
    14. Juan Oliva & Félix Lobo & Julio López-Bastida & Néboa Zozaya & Rosa Romay, 2005. "Indirect costs of cervical and breast cancers in Spain," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(4), pages 309-313, December.
    15. Koopmanschap, Marc A. & Rutten, Frans F. H. & van Ineveld, B. Martin & van Roijen, Leona, 1997. "Reply to Johanneson's and Karlsson's comment," Journal of Health Economics, Elsevier, vol. 16(2), pages 257-259, April.
    16. Brouwer, W. B. F. & Koopmanschap, M. A. & Rutten, F. F. H., 1999. "Productivity losses without absence: measurement validation and empirical evidence," Health Policy, Elsevier, vol. 48(1), pages 13-27, July.
    17. Ara, R & Brazier, JE, 2010. "Using health state utility values from the general population to approximate baselines in decision analytic models when condition specific data are not available," MPRA Paper 29946, University Library of Munich, Germany.
    18. Hanly, Paul & Ortega Ortega, Marta & Pearce, Alison & Soerjomataram, Isabelle & Sharp, Linda, 2020. "Advances in the methodological approach to friction period estimation: A European perspective," Social Science & Medicine, Elsevier, vol. 264(C).
    19. Carmen Herrero & Juan D. Moreno‐Ternero, 2009. "Estimating production costs in the economic evaluation of health‐care programs," Health Economics, John Wiley & Sons, Ltd., vol. 18(1), pages 21-35, January.
    20. Brouwer, W. B. F. & van Exel, N. J. A. & Koopmanschap, M. A. & Rutten, F. F. H., 2002. "Productivity costs before and after absence from work: as important as common?," Health Policy, Elsevier, vol. 61(2), pages 173-187, August.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0169344. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.