Societal costs and burden of otitis media in Portugal

Figures & data

Table 1 Unit costs associated with otitis media in Portugal

	Costs (€)	Comments/reference
Direct medical costs
General practitioner visit*	31	Ministry of Health, 2009
Home visit by general practitioner*	42	Ministry of Health, 2009
Outpatient pediatrician visit*	31	Ministry of Health, 2009
Outpatient ear-nose-throat specialist visit*	31	Ministry of Health, 2009
Outpatient consult other medical doctor*	31 or 85 or 100	Depending on doctor, Ministry of Health, 2009
Telephone consultation medical doctor*	25	Ministry of Health, 2009
Emergency department visit*	147	Ministry of Health, 2009
Hospital stay (1 day with overnight stay)*	78.02	Ministry of Health, 2009
Accompanying person hospital stay*	112.50	Ministry of Health, 2009
Antibiotics treatment		As filled out by the respondents or when missing 9.55; Ministry of Health, 2009
Other prescribed drugs		As filled out by the respondents
OTC drugs		As filled out by the respondents
Direct nonmedical costs
Cost of 1 km travelled by car	0.40	Public Administration Legislation, 2009
Public transportation costs		As filled out by the respondents
Taxi costs		As filled out by the respondents
Indirect costs
Absence paid job: average hourly wage paid job
Mother	5.59	Ministry of Work and Social Security, 2009
Father	7.41	Ministry of Work and Social Security, 2009
Grandparent	6.50	Ministry of Work and Social Security, 2009
Hours productivity lost: average hourly wage paid job
Mother	5.59	Ministry of Work and Social Security, 2009
Father	7.41	Ministry of Work and Social Security, 2009
Absence unpaid job: average hourly wage unpaid job	3.00	Ministry of Work and Social Security, 2009
Average hourly cost of leisure time loss	3.00	Ministry of Work and Social Security, 2009

Note:

* Unit costs for National Health Service.

Table 2 Characteristics of the respondents and children

	n (%)	n (%)
	All respondents (n = 1769)	MD-OM (n = 203)
Respondents
Gender, female	893 (50.5)	98 (48.3)
Mean age ± SD in years (range)	30.7 ± 5.2 (16.0–65.0)	30.7 ± 4.8 (18.0–49.0)
Level of education*
Basic	220 (12.4)	34 (16.7)
Secondary	668 (37.8)	72 (35.5)
Higher	768 (43.4)	79 (38.9)
Postgraduate	113 (6.4)	18 (8.9)
Regions
Viana do Castelo	20 (1.1)	5 (2.5)
Vila Real	21 (1.2)	1 (0.5)
Braga	107 (6.0)	11 (5.4)
Bragança	11 (0.6)	0
Porto	308 (17.4)	28 (13.8)
Viseu	45 (2.5)	9 (4.4)
Aveiro	123 (7.0)	15 (7.4)
Guarda	17 (1.0)	2 (1.0)
Coimbra	97 (5.5)	10 (4.9)
Castelo Branco	34 (1.9)	1 (0.5)
Leiria	87 (4.9)	11 (5.4)
Santarém	64 (3.6)	6 (3.0)
Portalegre	25 (1.4)	4 (2.0)
Lisboa	451 (25.5)	60 (29.6)
Setúbal	201 (11.4)	21 (10.3)
Beja	17 (1.0)	2 (1.0)
Évora	20 (1.1)	3 (1.5)
Faro	73 (4.1)	9 (4.4)
Região Autónoma da Madeira	24 (1.4)	4 (2.0)
Região Autónoma dos Açores	24 (1.4)	1 (0.5)
Paid job; mean number of hours per week** ± SD (range)	1,441 (81.5); 37.8 ± 10.4 hours (range 3.0–100.0)	175 (86.2); 38.2 ± 12.3 hours (range 5.0–100.0)
Gross yearly household income (median)	20,000–29,999 Euros	20,000–29,999 Euros
Mean number of children (<5 years) per respondent	1.1 children	1.1 children
Children/episodes
Gender; girls	768 (43.4)	94 (46.3)
Mean age ± SD in years (range)	2.5 ± 1.5 (range 0.1–4.9)	2.5 ± 1.5 (range 0.1–4.9)
Age distribution
0 year	381 (21.5)	47 (23.2)
0–6 months	156 (8.8)	24 (11.8)
6–12 months	225 (12.7)	23 (11.3)
1 year	364 (20.6)	31 (15.3)
2 years	369 (20.9)	51 (25.1)
3 years	264 (14.9)	25 (12.3)
4 years	391 (22.1)	49 (24.1)

Notes:

* Basic: 4th grade; 9th grade; Secondary: 12th grade; Higher: Degree (licenciatura-4 to 6 years); Postgraduate studies: Masters, PhD.

Abbreviations: SD, standard deviation; MD-OM, doctor-diagnosed otitis media.

Table 3 Use of medical resources for episodes of doctor-diagnosed otitis media

	n = 203
Doctor* consultation, %, mean visits per episode (range)
GP	25.1, 2.1 (1–6)
GP home visit	3.9, 1.9 (1–5)
Pediatrician	46.3, 2.1 (1–9)
Emergency department visit	34.0, 1.8 (1–10)
Ear-nose-throat specialist	8.4, 2.7 (1–6)
Other medical doctor	2.0, 1.2 (1–2)
Telephone doctor consultation	3.9, 3.5 (1–12)
Hospital admission, % (mean duration, days)
Without overnight stay	1.5 (1.0)
Including overnight stay	4.4 (3.9)
Drug prescription, n (%)
Drugs prescribed	196 (96.6)
Antibiotics	186 (91.6)
In children aged 0 year	43 (91.5)
In children aged 1 year	28 (90.3)
In children aged 2 years	47 (92.2)
In children aged 3 years	22 (88.0)
In children aged 4 years	46 (93.9)
Other drugs	21 (10.3)
No drugs prescribed	7 (3.4)
Nonprescription drugs, n (%)	100 (49.3)

Note:

* More than one option could be filled out.

Abbreviations: SD, standard deviation; GP, general practitioner.

Table 4 Productivity loss and travel-related costs for episodes with doctor-diagnosed otitis media

	n = 203
Paid work
Children for whom caregivers* had to stay home, n (%)	55 (27.1)
Mean ± SD absence, hours (range)†	19.8 ± 23.0 hours (1.0–160.0)
Median absence in hours	16.0
Unpaid work
Children for whom caregivers had to stay home, n (%)	28 (13.8)
Mean ± SD absence, hours (range)†	13.8 ± 12.7 hours (1.0–51.0)
Median absence, hours	8.0
Loss of work productivity
Parents reporting loss of productivity, n (%)	131 (64.5)
Mean ± SD loss of productivity loss, hours (range)‡,†	21.0 ± 25.3 hours (0–144.0)
Median productivity loss, hours	14.0
Loss of leisure time
Parents reporting loss of leisure time, n (%)	145 (71.4)
Mean ± SD loss of leisure time, hours (range)*,†	3.5 ± 8.5 (0.1–100.0)
Median loss of leisure time, hours	2.0
Travel-related costs
Car km
Parents reporting car km, n (%)	158 (77.8)
Mean car km ± SD (range)*,†	15.4 ± 18.9 (0.5–150)
Median car km	10.0
Public transportation costs
Parents reporting public transportation costs, n (%)	4 (2.0)
Taxi costs
Parents reporting taxi costs, n (%)	1 (0.5)

Notes:

* Mother, father, grandparent, other;

† population = caregivers who reported productivity loss;

‡ parents.

Abbreviation: SD, standard deviation.

Table 5 Direct medical, direct nonmedical, indirect and total costs of doctor-diagnosed otitis media episodes and economic burden of otitis media in Portugal

	MD-OM	MD-OM
	Internet survey (n = 203)	Portugal (n = 214,648)
Direct medical costs (€)
Total costs	40,443
Mean costs per episode (95% CI) ± SD	199 (164–234) ± 253
Median costs per episode	137
Range costs per episode	20–2227
Total costs to society (95% CI)		42,714,952 (35,202,272–50,227,632)
Direct nonmedical costs (€)
Total costs	1010
Mean costs per episode (95% CI) ± SD	5 (4–6) ± 7
Median costs per episode	2
Range costs per episode	0–60
Total costs to society (95% CI)		1,073,240 (858,592–1,287,888)
Indirect costs (€)
Total costs	26,355
Mean costs per episode (95% CI) ± SD	130 (101–159) ± 209
Median costs per episode	69
Range costs per episode	0–1519
Total costs to society (95% CI)		27,904,240 (21,679,448–34,129,032)
Total costs (€)
Total costs	67,808
Mean costs per episode (95% CI) ± SD	334 (286–382) ± 348
Median costs per episode	226
Range costs per episode	25–2369
Total costs to society (95% CI)		71,692,432 (61,389,328–81,995,536)

Abbreviations: CI, confidence interval; MD-OM, doctor-diagnosed otitis media; SD, standard deviation.