The economic impact of coccidioidomycosis in Kern County, California, 1991 to 1993

Caldwell, J. W.;Welch, G.;Johnson, R. H.;Einstein, H. E.


An unprecedented epidemic of coccidioidomycosis began in 1991 in the Southern San Joaquin Valley of California. Data from medical records and patient interviews of 536 cases with laboratory-confirmed diagnosis from the Kern County Health Department were analyzed for hospital days, return clinic visits, drug usage, and employment status. Estimates of work days missed were made from historical and current data from the military. Usual costs for hospital days and return clinic visits, and average wholesale acquisition prices for antifungal medications were utilized for medical costs. Lost wages were estimated from the employment rate in the epidemic population and salary estimates according to race from the 1990 census in Kern County.A total yearly cost per case of $8,096 was calculated from this analysis, with 63 percent attributed to hospitalization, 18 percent to clinic visits, 12 percent to lost wages, and 7 percent to the cost of drug treatment. Nondisseminated cases averaged $5,400 as compared to $48,000 for those with dissemination. Twenty-three percent of total cost was due to disseminated disease, which was present in only 4 percent of the infected population.The total estimated cost for 7,130 cases occurring from 1991 to 1993, utilizing these methods, is more than $56 million. This does not include the cumulative costs of continuing care, beyond 1 year, for those with chronic disease and disability.

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Full conference title: 

Coccidioidomycosis - Centennial Conference
    • Coccidioidomycosis