The cost of hospital care for management of invasive group A streptococcal infections in England

Epidemiol Infect. 2015 Jun;143(8):1719-30. doi: 10.1017/S0950268814002489. Epub 2014 Sep 29.


The objective of this study was to estimate the direct financial costs of hospital care for management of invasive group A streptococcal (GAS) infections using hospital records for cases diagnosed in England. We linked laboratory-confirmed cases (n = 3696) identified through national surveillance to hospital episode statistics and reimbursement codes. From these codes we estimated the direct hospital costs of admissions. Almost all notified invasive GAS cases (92% of 3696) were successfully matched to a primary hospital admission. Of these, secondary admissions (within 30 days of primary admission) were further identified for 593 (17%). After exclusion of nosocomial cases (12%), the median costs of primary and secondary hospital admissions were estimated by subgroup analysis as £1984-£2212 per case, totalling £4·43-£6·34 million per year in England. With adjustment for unmatched cases this equated to £4·84-£6·93 million per year. Adults aged 16-64 years accounted for 48% of costs but only 40% of cases, largely due to an increased number of surgical procedures. The direct costs of hospital admissions for invasive GAS infection are substantial. These estimated costs will contribute to a full assessment of the total economic burden of invasive GAS infection as a means to assess potential savings through prevention measures.

Keywords: treatment costs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Child, Preschool
  • Critical Care / economics*
  • England / epidemiology
  • Fasciitis, Necrotizing / economics*
  • Fasciitis, Necrotizing / epidemiology
  • Female
  • Hospital Costs*
  • Hospitalization / economics*
  • Humans
  • Infant
  • Infant, Newborn
  • Length of Stay / economics
  • Male
  • Middle Aged
  • Pneumonia, Bacterial / economics*
  • Pneumonia, Bacterial / epidemiology
  • Sepsis / economics*
  • Sepsis / epidemiology
  • Soft Tissue Infections / economics*
  • Soft Tissue Infections / epidemiology
  • Streptococcal Infections / economics*
  • Streptococcal Infections / epidemiology
  • Streptococcus pyogenes*
  • Young Adult