Abstract
Background: Bronchiectasis, a previously neglected condition, now has renewed research interest. There are a few systematic reviews that have reported on the economic and societal burden of bronchiectasis in adults, but none have reported on children. We undertook this systematic review to estimate the economic burden of bronchiectasis in children and adults. Research Question: What is the health care resource utilization and economic burden of bronchiectasis in adults and children? Study Design and Methods: We performed a systematic review identifying publications from Embase, PubMed, Web of Science, Cochrane (trials, reviews, and editorials), and EconLit about the economic burden and health care utilization in adults and children with bronchiectasis between January 1, 2001, and October 10, 2022. We used a narrative synthesis approach and estimated aggregate costs for several countries. Results: We identified 53 publications reporting on the economic burden and/or health care utilization of people with bronchiectasis. Total annual health care costs per adult patient ranged from 2021 $3,579 to $82,545 USD and were predominantly driven by hospitalization costs. Annual indirect costs including lost income because of illness (reported in only five studies) ranged from $1,311 to $2,898 USD. Total health care costs in children with bronchiectasis were $23,687 USD annually in the one study that estimated them. Additionally, one publication found that children with bronchiectasis missed 12 school days per year. We estimated aggregate annual health care costs for nine countries, ranging from $101.6 million per year in Singapore to $14.68 billion per year in the United States. We also estimated the aggregate cost of bronchiectasis in Australian children to be $17.77 million per year. Interpretation: This review highlights the substantial economic burden of bronchiectasis for patients and health systems. To our knowledge, it is the first systematic review to include the costs for children with bronchiectasis and their families. Future research to examine the economic impact of bronchiectasis in children and economically disadvantaged communities, and to further understand the indirect burden of bronchiectasis on individuals and the community, is needed.
| Original language | English |
|---|---|
| Pages (from-to) | 1396-1421 |
| Number of pages | 26 |
| Journal | Chest |
| Volume | 164 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Dec 2023 |
Bibliographical note
Funding Information:J. M. R. is supported by a scholarship from the NHMRC Centre of Research Excellence for bronchiectasis in children [Grant APP1170958] and an Australian Government Research Training Program scholarship. J. M. M. is supported by a Children’s Hospital Foundation fellowship [Grant RPC0772019] and Lung Foundation Australia fellowship in bronchiectasis. A. B. C. is supported by an NHMRC Senior Practitioner Fellowship [Grant APP1154302]. V. G. is supported by a Queensland Advancing Research Fellowship and Royal Australasian College of Physician’s Research Establishment Fellowship [Grant 2022REF00054].
Funding Information:
Author contributions: J. M. R. takes responsibility for the content of the manuscript, including the data and analysis. P. C. G. F. H. and J. D. C. designed the original search strategy, which was modified for this review by J. M. R. J. M. M. S. K. V. G. and A. B. C. The search was performed by J. M. R. and articles were screened for inclusion by J. M. R. J. M. M. and V. G. and adjudicated by S. K. The first draft of the manuscript was performed by J. M. R. J. M. M. V. G. and S. K. which was critically reviewed by J. M. R. V. G. S. K. A. B. C. N. K. and S. M. M. who provided clinical, academic, and technical insight. Role of sponsors: The sponsor had no role in the design of the study, the collection and analysis of the data, or the preparation of the manuscript. Other contributions: We thank Goeminne et al 12 for supplying the documentation for their systematic review that the current review was based on; Cameron Rutter (GradDip InfoSc/Stud) for librarian support and guidance on performing the searches; Ouzzani et al 83 for the Rayyan title and abstract screening tool; the developers of R, R studio, and the Tidyverse for their data analysis packages; and the members of the Australian Centre for Health Services Innovation and the Cough and Airways Research Group for their ongoing support. Additional information: The e-Appendixes and e-Tables are available online under “Supplementary Data.”
Publisher Copyright:
© 2023 American College of Chest Physicians