Burden of varicella complications in secondary care, England, 2004 to 2017

James Lopez Bernal*, Peter Hobbelen, Gayatri Amirthalingam

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

BackgroundStrategies to control varicella vary across Europe. Evidence from established programmes has prompted the United Kingdom to re-evaluate the need for universal vaccination. The burden of complicated varicella is a key parameter in the cost-effectiveness analysis.AimOur objective was to estimate the burden of complicated varicella in England.MethodsThis electronic health record surveillance study used data from all NHS hospitals in England to identify varicella admissions between 2004 and 2017. The incidence of pre-defined complications of varicella was estimated using ICD-10 codes. Inpatient costs were calculated based on the payment rules for providers of NHS services.ResultsThere were 61,024 admissions with varicella between 2004 and 2017 and 38.1% had a recognised varicella complication. Incidence of hospitalisation increased by 25% and the proportion with complicated varicella by 24% from 2004/05 to 2016/17. The most common complications were bacterial skin infections (11.25%), pneumonia (4.82%), febrile convulsions (3.39%) and encephalitis (2.44%). Complication rates were higher in older age groups and the type of complications more severe. Length of stay for complicated varicella was 3.1 times longer than for uncomplicated varicella and inpatient costs were 72% greater.ConclusionComplicated varicella has a substantial health and economic burden. These data together with data on impact on quality of life are important in informing the cost-effectiveness analysis of universal varicella vaccination.

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Secondary Care
Chickenpox
England
International Classification of Diseases
Cost-Benefit Analysis
Inpatients
Vaccination
Costs and Cost Analysis
Febrile Seizures
Electronic Health Records
Incidence
Encephalitis
Bacterial Infections
Length of Stay
Pneumonia
Hospitalization
Age Groups

Keywords

  • chickenpox
  • comorbidity
  • cost
  • epidemiology
  • vaccine
  • varicella zoster virus infection

Cite this

@article{ea631cc8dc4b47f186a6003baf78f7d0,
title = "Burden of varicella complications in secondary care, England, 2004 to 2017",
abstract = "BackgroundStrategies to control varicella vary across Europe. Evidence from established programmes has prompted the United Kingdom to re-evaluate the need for universal vaccination. The burden of complicated varicella is a key parameter in the cost-effectiveness analysis.AimOur objective was to estimate the burden of complicated varicella in England.MethodsThis electronic health record surveillance study used data from all NHS hospitals in England to identify varicella admissions between 2004 and 2017. The incidence of pre-defined complications of varicella was estimated using ICD-10 codes. Inpatient costs were calculated based on the payment rules for providers of NHS services.ResultsThere were 61,024 admissions with varicella between 2004 and 2017 and 38.1{\%} had a recognised varicella complication. Incidence of hospitalisation increased by 25{\%} and the proportion with complicated varicella by 24{\%} from 2004/05 to 2016/17. The most common complications were bacterial skin infections (11.25{\%}), pneumonia (4.82{\%}), febrile convulsions (3.39{\%}) and encephalitis (2.44{\%}). Complication rates were higher in older age groups and the type of complications more severe. Length of stay for complicated varicella was 3.1 times longer than for uncomplicated varicella and inpatient costs were 72{\%} greater.ConclusionComplicated varicella has a substantial health and economic burden. These data together with data on impact on quality of life are important in informing the cost-effectiveness analysis of universal varicella vaccination.",
keywords = "chickenpox, comorbidity, cost, epidemiology, vaccine, varicella zoster virus infection",
author = "Bernal, {James Lopez} and Peter Hobbelen and Gayatri Amirthalingam",
year = "2019",
month = "10",
day = "1",
doi = "10.2807/1560-7917.ES.2019.24.42.1900233",
language = "English",
volume = "24",
journal = "Eurosurveillance",
issn = "1025-496X",
publisher = "European Centre for Disease Prevention and Control",
number = "42",

}

Burden of varicella complications in secondary care, England, 2004 to 2017. / Bernal, James Lopez; Hobbelen, Peter; Amirthalingam, Gayatri.

In: Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin, Vol. 24, No. 42, 01.10.2019.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Burden of varicella complications in secondary care, England, 2004 to 2017

AU - Bernal, James Lopez

AU - Hobbelen, Peter

AU - Amirthalingam, Gayatri

PY - 2019/10/1

Y1 - 2019/10/1

N2 - BackgroundStrategies to control varicella vary across Europe. Evidence from established programmes has prompted the United Kingdom to re-evaluate the need for universal vaccination. The burden of complicated varicella is a key parameter in the cost-effectiveness analysis.AimOur objective was to estimate the burden of complicated varicella in England.MethodsThis electronic health record surveillance study used data from all NHS hospitals in England to identify varicella admissions between 2004 and 2017. The incidence of pre-defined complications of varicella was estimated using ICD-10 codes. Inpatient costs were calculated based on the payment rules for providers of NHS services.ResultsThere were 61,024 admissions with varicella between 2004 and 2017 and 38.1% had a recognised varicella complication. Incidence of hospitalisation increased by 25% and the proportion with complicated varicella by 24% from 2004/05 to 2016/17. The most common complications were bacterial skin infections (11.25%), pneumonia (4.82%), febrile convulsions (3.39%) and encephalitis (2.44%). Complication rates were higher in older age groups and the type of complications more severe. Length of stay for complicated varicella was 3.1 times longer than for uncomplicated varicella and inpatient costs were 72% greater.ConclusionComplicated varicella has a substantial health and economic burden. These data together with data on impact on quality of life are important in informing the cost-effectiveness analysis of universal varicella vaccination.

AB - BackgroundStrategies to control varicella vary across Europe. Evidence from established programmes has prompted the United Kingdom to re-evaluate the need for universal vaccination. The burden of complicated varicella is a key parameter in the cost-effectiveness analysis.AimOur objective was to estimate the burden of complicated varicella in England.MethodsThis electronic health record surveillance study used data from all NHS hospitals in England to identify varicella admissions between 2004 and 2017. The incidence of pre-defined complications of varicella was estimated using ICD-10 codes. Inpatient costs were calculated based on the payment rules for providers of NHS services.ResultsThere were 61,024 admissions with varicella between 2004 and 2017 and 38.1% had a recognised varicella complication. Incidence of hospitalisation increased by 25% and the proportion with complicated varicella by 24% from 2004/05 to 2016/17. The most common complications were bacterial skin infections (11.25%), pneumonia (4.82%), febrile convulsions (3.39%) and encephalitis (2.44%). Complication rates were higher in older age groups and the type of complications more severe. Length of stay for complicated varicella was 3.1 times longer than for uncomplicated varicella and inpatient costs were 72% greater.ConclusionComplicated varicella has a substantial health and economic burden. These data together with data on impact on quality of life are important in informing the cost-effectiveness analysis of universal varicella vaccination.

KW - chickenpox

KW - comorbidity

KW - cost

KW - epidemiology

KW - vaccine

KW - varicella zoster virus infection

U2 - 10.2807/1560-7917.ES.2019.24.42.1900233

DO - 10.2807/1560-7917.ES.2019.24.42.1900233

M3 - Article

VL - 24

JO - Eurosurveillance

JF - Eurosurveillance

SN - 1025-496X

IS - 42

ER -