Cost of care and clinical condition in paediatric cystic fibrosis patients.

Background: The clinical course of cystic fibrosis (CF) shows considerable variation resulting in differences in health care utilisation. We investigated important clinical parameters and their relation to costs.

Methods: We collected clinical parameters together with health care utilisation of a representative paediatric CF population (n=138 patients) attending Hanover Medical School over a period of 1 year. 49% of the patients were chronically infected with Pseudomonas aeruginosa. Costs were calculated on the basis of the annual individual health care utilisation from the perspective of health insurance.

Results: Total annual expenditure per patient amounted to 23,989 euro (S.D. 18,026), with home drug treatment representing the most important single cost factor (47% of total costs). While costs rose with age and doubled in the first 18 years, they correlated foremost with P. aeruginosa airway colonisation status and lung function expressed as FEV(1). Costs of patients with chronic P. aeruginosa infection were more than three times higher than of uninfected patients.

Conclusions: Health care expenditures for patients with CF vary with the clinical course. The variation can be explained to a large extend by clinical parameters.