Morbidity Sample Clauses

Morbidity. The standard cost of illness approach is used for acute hospitalizations, and consists in applying a unit economic value approach to each case, including direct and indirect costs.

Morbidity. Young infants are particularly vulnerable to severe morbidity and mortality resulting from pertussis. In the U.S., approximately two-thirds of infants under 6 months of age with reported pertussis are hospitalized (69, 70). During recent pertussis epidemics in California, most of the hospitalizations were infants <6 months of age (9, 60, 71). The hospitalization rate among infants <6 months was 46% (9); length of hospital stay is longer for infants <6 months (9.3 days) compared with children 6 months or older (4.9 days, p<.001) and intensive care is more frequently required for infants <6 months (19% of those hospitalized) compared to children 6 months or older (5%, p<.01) (72). The most common pertussis-related complication experienced by young infants is secondary bacterial pneumonia. Among infants <3 months of age with pertussis, as many as 5.2% acquire secondary bacterial pneumonia, and among infants <6 months of age with pertussis, up to 11.8% acquire secondary bacterial pneumonia, more than double the incidence in older children and adults (1). In the U.S. between 1993 and 2004, 95% of pertussis-infected infants who required mechanical ventilation and all of those who died were aged 3 months or younger (13).

Morbidity. Many studies have shown a decrease in the incidence of RDS in infants whose mothers received antenatal steroids. Crowley15, in his meta-analysis of random- ized trials from 1972-1994, found that antenatal corticosteroid therapy results in an overall reduction of approximately 50% in the odds of contracting neonatal RDS. Regarding these findings and the increased use of antenatal steroids, we expected to find a decrease in the incidence of RDS. The incidence of RDS however, was approximately the same in the 1980s (57%) and 1990s (60%).While the incidence of RDS remained the same, mortality from RDS significantly decreased. This suggests that the severity of RDS is reduced by antenatal treat- ment with corticosteroids. In the LFUPP-1996/97 cohort, we did indeed find a smaller percentage of infants with severe RDS within the group antenatally treated with a full course of corticosteroids than in the non-treated or incom- pletely treated infants. Besides this, survival of infants with severe RDS is now better because of treatment with surfactant. The increased survival of infants with RDS was associated with an increase in the percentage of infants with BPD. BPD was defined according to ▇▇▇▇▇▇▇ in the LFUPP-1996/97 and according to Bancalari in the POPS-1983. The per- centage of infants with BPD in the POPS-1983-cohort would probably have been even lower if the Shennan-definition was used since it is not likely that all infants who were oxygen dependent at 28 days post partum would still be at 36 weeks’ postmenstrual age. Unfortunately, chart review of POPS-cases to verify this did not yield the necessary data. A shift towards less serious IVH was found. Although not significant, in the LFUPP-1996/97 cohort, IVH occurred less frequently in infants whose moth- ers were antenatally treated with a complete course of corticosteroids. A positive influence of antenatal corticosteroids on the incidence of IVH has been found in many studies. The previously mentioned meta-analysis by ▇▇▇▇▇▇▇▇▇ showed that corticosteroid therapy reduces the odds of periventricular hemorrhage (odds ratio [OR]: 0.38; 95% confidence interval: 0.23-0.94). ▇▇▇▇▇▇▇▇▇ et al.16 found an odds ratio of 0.39 (95% confidence interval: 0.27-0.57) for the association of a complete course of steroids with grades 3 and 4 IVH. Sepsis, defined as a positive blood culture, occurred more frequently in the LFUPP-1996/97 group. This could not be explained by a more frequent use of lines, 65 % (163 of 249) of the LFUPP...

Morbidity. This approach (referred to as Cost Of Illness, COI) is especially suitable for the assessment of medical treatment costs, including hospitalizations and productivity losses due to health outcomes. It consists in directly interviewing patients or in scrutinizing the health expenditure data of patients to compute a cost related to the disease. This approach is easy to implement but cannot account for intangible costs like the assessment of pain, grief and suffering as there are no market prices for these cost factors. Note that it relies on prices and tariffs generally fixed by Governments.