Economic burden of herpes zoster among skilled nursing facility residents in the United States.

Objectives: To evaluate health care resource use and direct medical costs attributable to herpes zoster (HZ) among elderly residents of skilled nursing facilities (SNF).

Methods: This was a retrospective matched cohort study using data from 300 SNF in the United States. A total of 404 patients with HZ were matched with 1616 patients with no documented HZ or post-herpetic neuralgia using propensity scores. The study period included a 1-month pre-index period and the 90-day acute/subacute phase following the HZ index date. Health care resource utilization was captured from the long term care minimum dataset (MDS) and SNF admission-discharge records. The direct medical costs consisted of the SNF net bed revenue and hospitalization cost.

Results: Over the 4-month study period, significantly more patients were hospitalized among the HZ (20.5%) than non-HZ cohort (14.4%). Both the numbers of hospitalization episodes and hospitalization days were greater for HZ than for non-HZ patients. An average additional 0.09 hospitalization episodes and 0.55 days of hospitalization were estimated in a multivariate model for patients in the HZ compared with the non-HZ cohort. The incremental direct medical costs, which are composed of the incremental medical costs incurred in the SNF, and the incremental costs attributable to hospitalization, were estimated between $1079 and $1673 for patients with HZ.

Conclusion: In the SNF setting, the presence of HZ imposes significant health care resource utilization and direct medical costs.