Physician's Capitation Trends: Flu season offers chance to save lives, cut costs
Physician's Capitation Trends
Flu season offers chance to save lives, cut costs
Broaden vaccination rate, improve prescribing
It’s time to start bracing for flu season. According to a recent drug company-sponsored study, average costs for treating flu is a jolting $1,000 per person.
As flu has taken a tighter grip on virtually all ages, hospitalizations are increasing, which means associated costs and risks are increasing as well. The best way to combat the devastating effects of flu, according to the Research Triangle Park, NC-based Glaxo-Wellcome study, is to take these two measures:
1. Improve vaccination rates.
2. Use antibiotic or antiviral agents, when appropriate, if flu sets in.
Lead researcher Fred Cox, PhD, and his team set out to assess costs and treatments of patients with and without secondary viral or bacterial infections in a managed care setting. They studied records of 18,000 patients with a principal diagnosis of influenza (ICD-9-CM code 487). Of that study cluster, records were divided into three groups: influenza only (INF), influenza plus a secondary bacterial respiratory infection (BRI), and influenza with a secondary viral respiratory infection (VRI).
Here are the mean total treatment costs they found among the three groups:
• INF — $602
• VRI — $847
• BRI — $5,593
The cost differences were primarily driven by differences in hospitalization costs. Mean total inpatient costs among the three types of flu broke out this way:
• INF — $138
• VRI — $208
• BRI — $3509
Hospital admission rates among the groups are substantially higher for the BRI group, while relatively close between INF and VRI. They varied in this way:
• INF — .03 hospitalizations per patient
• VRI — .06 hospitalizations per patient
• BRI — .5 hospitalizations per patient
These data suggest a significant need to better vaccinate and to better prescribe, Fox and team contend. "It has been reported that 90% of the people who die each year of influenza are over the age of 65," they write.
"This fact, coupled with the serious nature of influenza, supports the recommendation that at-risk patients, such as the elderly, immunocompromised patients, or those with chronic diseases, take prophylactic measures to guard against influenza infection. However, studies show that only 20% to 60% of persons in high-risk groups are vaccinated," the researchers add.
In the study sample, less than 10% of patients who had contracted flu had received a vaccination. Also amid those patients, researchers found misguided prescribing: too much of some drugs that won’t help and too little of others drugs that could help. For example, of the study sample, 36% of VRI patients and 28% of INF patients received antibiotics (which won’t help); 7% of VRI patients received antiviral drugs (which could have helped).
Broader vaccination for prevention and better drug prescribing when flu incurs could go a long way toward cutting back high costs, Cox and team recommend. In their study, the 18,000 flu patients amounted to $12.8 million in medical costs with 35% coming from inpatient costs.
Early introduction of the correct drugs can avert hospitalizations, which alleviates higher costs and higher illness levels.
"Given the high cost of hospitalization for this illness," Cox writes, "The introduction of effective treatment in the outpatient setting, such as the newer antiviral agents or more aggressive vaccination programs, could have a significant impact on the cost of treating influenza."
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