[Direct medical costs and influencing factors of pertussis cases in children in Zhejiang Province].

Objective

To assess the direct medical cost of pertussis cases among children in Zhejiang Province and identify the associated factors.

Methods

Laboratory-confirmed pertussis cases diagnosed in 2022 at the Children's Hospital, Zhejiang University School of Medicine were included. Data on demographic characteristics, vaccination status, healthcare utilization and direct medical costs were collected from the China Information System for Disease Control and Prevention, the hospital information system, and the Zhejiang Provincial Immunization Program Information System. In combination with the ptxP genotype of the isolates and erythromycin resistance, direct medical costs were analyzed. A generalized linear model with a Gamma distribution and log link function was used to identify factors associated with direct medical costs, and the results were presented as expβ (cost ratio).

Results

A total of 172 cases were included, with a male-to-female ratio of 1.00∶1.49 and a mean age of (4.29±3.48) years. The median direct medical cost [M (Q1, Q3)] was 1 629.97 (1 034.73, 3 706.98) yuan. Complications (cost ratio: 1.488, 95%CI: 1.108-1.997; P=0.008), hospitalization (cost ratio: 6.719, 95%CI: 4.432-10.184; P<0.001), and ≥3 outpatient visits (cost ratio: 3.121, 95%CI: 2.098-4.644; P<0.001) were significantly associated with increased direct medical costs, whereas age 10-15 years (cost ratio: 0.629, 95%CI: 0.411-0.963; P=0.033) and completion of the 4-dose vaccination schedule (cost ratio: 0.649, 95%CI: 0.427-0.987; P=0.043) were associated with lower direct medical costs.

Conclusion

The economic burden of pertussis cases among children in Zhejiang Province is considerable. Disease severity, healthcare utilization, and vaccination status are the main factors influencing direct medical costs.