Table 5.
Mean annual estimates of the direct and indirect cost of influenza‐associated illness by syndrome in South Africa, 2013‐2015 (main analysis using influenza‐associated illness specific costs)
| Parameter | Respiratory value (95% CI) | Circulatory value (95% CI) | Non‐respiratory/non‐circulatory value (95% CI) |
|---|---|---|---|
| Medically attended severe illness (hospitalization) | |||
| Total absenteeism (d) | 132 259 (57 588‐250 458) | 34 828 (10 664‐88 764) | 42 485 (16 367‐101 346) |
| Absenteeism from school | 23 523 (8022‐42 318) | 1413 (405‐3477) | 5795 (3495‐11 056) |
| Absenteeism from worka | 108 736 (63 067‐154 405) | 33 415 (19 381‐47 449) | 36 690 (21 280‐52 100) |
| Total cost ($) | 29 615 038 (11 024 277‐64 591 790) | 7 951 535 (2 564 349‐25 204 526) | 9 513 216 (3 133 104‐26 136 702) |
| Direct cost | 28 208 096 (10 529 730‐61 462 487) | 7 580 920 (2 471 988‐24 095 517) | 9 061 265 (2 992 553‐24 870 447) |
| Healthcare system | 27 638 889 (10 316 551‐60 350 017) | 7 477 273 (2 440 971‐23 815 716) | 8 878 419 (2 931 968‐24 420 292) |
| Out‐of‐pocketa | 569 207 (213 179‐1 112 470) | 103 647 (31 017‐279 801) | 182 846 (60 585‐450 155) |
| Indirect costa | 1 406 942 (494 547‐3 129 303) | 370 614 (92 360‐1 109 009) | 451 951 (140 550‐1 266 255) |
| Medically attended mild illness (outpatient consultation) | |||
| Total absenteeism (d) | 3 730 033 (870 285‐6 789 121) | 2478 (949‐6419) | 9801 (2611‐22 013) |
| Absenteeism from school | 2 519 832 (920 215‐3 916 914) | 439 (218‐943) | 1280 (415‐2532) |
| Absenteeism from worka | 1 210 201 (871 345‐1 549 057) | 2039 (1468‐2610) | 8521 (6135‐10 907) |
| Total cost ($) | 107 633 247 (35 114 554‐173 444 720) | 71 506 (38 272‐163 983) | 282 814 (105 352‐562 368) |
| Direct cost | 73 545 226 (28 912 663‐97 455 060) | 48 859 (31 513‐92 138) | 193 245 (86 745‐315 983) |
| Healthcare system | 67 078 103 (27 052 096‐87 028 910) | 44 563 (29 485‐82 281) | 176 252 (81 163‐282 178) |
| Out‐of‐pocketa | 6 467 123 (1 860 567‐10 426 150) | 4296 (2028‐9857) | 16 993 (5582‐33 805) |
| Indirect costa | 34 088 021 (6 201 890‐75 989 661) | 22 646 (6760‐71 844) | 89 569 (18 607‐246 385) |
| Non‐medically attended mild and severe illness | |||
| Total absenteeism (d) | 9 170 313 (2 579 963‐15 989 327) | 37 653 (11 762‐99 659) | 65 026 (23 500‐167 376) |
| Absenteeism from school | 4 232 092 (1 724 301‐6 463 954) | 1808 (822‐5107) | 9198 (5536‐19 226) |
| Absenteeism from worka | 4 938 221 (855 662‐9 525 373) | 35 845 (10 940‐94 552) | 55 828 (17 964‐148 150) |
| Total cost ($) | 114 199 113 (27 963 705‐223 455 309) | 429 831 (126 957‐1 344 509) | 841 769 (276 534‐2 559 655) |
| Direct cost | 33 205 995 (13 496 244‐44 319 798) | 58 625 (28 199‐173 833) | 163 996 (74 374‐434 139) |
| Healthcare system | Not applicable | Not applicable | Not applicable |
| Out‐of‐pocketa | 33 205 995 (13 496 244‐44 319 798) | 58 625 (28 199‐173 833) | 163 996 (74 374‐434 139) |
| Indirect costa | 80 993 118 (14 467 461‐179 135 510) | 371 206 (98 758‐1 170 675) | 677 773 (202 160‐2 125 516) |
| Total of above categories | |||
| Total absenteeism (d) | 13 032 605 (3 507 836‐23 028 906) | 74 959 (23 375‐194 842) | 117 312 (42 478‐290 735) |
| Absenteeism from school | 6 775 447 (2 652 538‐10 423 186) | 3660 (1445‐9527) | 16 273 (9446‐32 814) |
| Absenteeism from worka | 6 257 158 (1 790 074‐11 228 835) | 71 299 (31 789‐144 611) | 101 039 (45 379‐211 157) |
| Total cost ($) | 251 447 398 (74 102 535‐461 491 819) | 8 452 870 (2 729 578‐26 713 016) | 10 637 799 (3 514 989‐29 258 725) |
| Direct cost | 134959317 (52 938 637‐203 237 345) | 7 688 404 (2 531 700‐24 361 488) | 9 418 506 (3 153 672‐25 620 569) |
| Healthcare system | 94 716 992 (37 368 647‐147 378 927) | 7 521 836 (2 470 456‐23 897 997) | 9 054 671 (3 013 131‐24 702 470) |
| Out‐of‐pocketa | 40 242 325 (15 569 990‐55 858 418) | 166 568 (61 244‐463 491) | 363 835 (140 541‐918 099) |
| Indirect costa | 116 488 081 (21 163 898‐258 254 474) | 764 466 (197 878‐2 351 528) | 1 219 293 (361 317‐3 638 156) |
Abbreviations: CI: confidence intervals
For this category, severe and mild cases are those meeting the World Health Organization (WHO) severe acute respiratory illness (SARI) and influenza‐like illness (ILI) case definitions, respectively. This is a subset of all‐respiratory illness.
a
Patient and caregiver.