This article is more than 5 years old. Information may no longer be current.

ED visits, cost associated with shingles increase

Emergency department visits and total cost associated with herpes zoster increased between 2006 and 2013, driven by an increased number of visits by patients aged 20 to 59 years, according to recently published study results in JAMA Dermatology.

Researchers used National Emergency Department Sample data to conduct a U.S. population-based study of ED visits related to herpes zoster (HZ) between 2006 and 2013, with cases of HZ identified by ICD-9-CM code.

Three age groups, 18 to 19 years (varicella vaccine recommended), 20 to 59 years (no vaccine recommended) and 60 years and older (HZ vaccine recommended), were used to stratify patients.

There were 1,350,957 ED visits (51.7% male; mean age, 54 years) during the study period.

There was an increase in the overall population-based rate for HZ-related ED visits from 51.57 to 59.44 per 100,000 persons per year (15.2%) between 2007 and 2013. There also was an increase from 0.13% to 0.14% (8.3%) in overall percentage of HZ-related ED visits during that time.

Patients aged 20 to 59 years had an increase from 0.12% to 0.14% of ED visits (22.8%) during the time. However, patients in the 18 to 19 years and 60 years or older age groups had a decrease in proportion of HZ-related ED visits, from 0.03% to 0.02% (–39.6%) and from 0.28% to 0.25% (–10.19%), respectively.

There was an increase in overall adjusted total charges (from $92.8 million to $202.47 million) and mean changes (from $763 to $1,262) for HZ-related ED visits during the time period for all age groups.

“Despite decreased utilization in patient aged less than 20 years and 60 years or older, we found increased total adjusted changes in these populations,” the researchers concluded. “Our findings suggest that vaccination may be associated with a reduction of ED utilization. Further research is necessary to identify the drivers of increased cost.”  – by Bruce Thiel

Disclosure: The researchers report no relevant financial disclosures.