OBJECTIVES: Meningococcal disease (MD) is a rare, life-threatening infection most common in infants (age < 1 year), adolescents, and persons living in close quarters. In this study, we documented trends in hospital costs, length of stay (LOS), and mortality associated with pediatric MD cases in the United States (US) from 2000 to 2009.
METHODS: Data for pediatric (age ≤ 20 years) MD-related hospitalizations (discharges with ICD-9-CM 036.xx) from the 2000, 2003, 2006, and 2009 HCUP Kids’ Inpatient Databases (KID) were retrospectively analyzed. Charges were converted to costs using a 0.5 cost-to-charge ratio. Weighted, nationally representative estimates of costs per admission (in 2012 US dollars), LOS, and case fatality rates were descriptively analyzed for each year.
RESULTS: By year, total (weighted) numbers of pediatric MD-related hospitalizations in the US were: 2000 (N= 1,680), 2003 (N= 1,089), 2006 (N= 745), 2009 (N= 581). Mean [SD] LOS for these hospitalizations was 8.4 [12.9] days in 2000, which decreased modestly to 7.7 [9.6] and 7.9 [8.3] days in 2003 and 2006, respectively, before a substantial increase to 9.3 [13.9] days in 2009. Mean [SD] cost per admission fluctuated accordingly, increasing from $25,739 [$60,929] in 2000 to $33,530 [$62,499] in 2009. Case fatality rates, however, remained relatively unchanged during the period, declining slightly from 4.7% in 2000 to 4.3% in 2009, although a noticeable spike occurred in 2003 when 5.8% of cases died.
CONCLUSIONS: MD in the US pediatric population is associated with high costs resulting from hospital stays that typical exceed 1 week. Our estimated case fatality rate (~5%), while high, is lower than the 10-15% fatality rate estimated by the US Centers for Disease Control, which includes estimates from all age groups combined (pediatrics and adults). In light of these findings, recent efforts to raise awareness of MD as a serious public health concern should be continued.
