Health-related quality of life and economic burden of childhood pneumonia in China: a multiregion study

OBJECTIVE: To systematically investigate the health-related quality of life (HRQOL) and economic burden of children with pneumonia in different regions of China. STUDY DESIGN: The study recruited a series of children under 5 years hospitalised for pneumonia in Shanghai, Zhengzhou and Kunming from January to October 2019. Health utility was assessed using the proxy version of EQ-5D-Y by interviewing patients’ guardians face to face. The assessment was administered twice at patients’ admission and discharge. Cost incurred for receiving the hospitalisation was collected. Multiple linear regression and quantile regression were used to explore factors of EQ-5D-Y Health Utility Score (HUS) and costs, respectively. RESULTS: A total of 501 paediatric patients with a median age (IQR) of 1.5 (0.83–2.71) years were included in the analysis. The mean HUS (SD) of the patients was 0.78 (0.18) at admission, and increased to 0.96 (0.10) at discharge. Some patients (14.2%) still felt worried, sad or unhappy after hospitalisation. The mean hospitalisation cost and total cost were RMB5859 (€773) and RMB6439, respectively. The HUS was lower and the economic burden was heavier for the children in Zhengzhou. Apart from region, type of work, insurance status and hospital days were also related to the baseline HUS or HUS increment after treatment; insurance status, Visual Analogue Scale score at discharge, guardians’ employment and hospitalisation days were associated with the costs. CONCLUSION: The children with pneumonia have poor baseline HRQOL, and many of them still have psychological well being problems after treatment. The economic burden varied significantly across regions and is heavy for the patients’ families in less developed areas (ie, Zhengzhou and Kunming).