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Direct costs of Acute Rhinosinusitis in Spain - a prospective and observational study (PROSINUS)

Jaume F1, Quintó LL5,6,7, Alobid I 2,3,4, Mullol J2,3,4

1Servei de Otorrinolaringologia, Hospital Comarcal d’Inca, Inca, Balears, Espanya 2Unitat de Rinologia i Clínica de l’Olfacte, Servei d’Otorinolaringologia, Hospital Clínic, Universitat de Barcelona. Barcelona, Catalonia, Spain
3Immunoal.lèrgia Respiratòria Clínica i Experimental, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS). Barcelona, Catalonia, Spain
4Centro de Investigación Biomédica En Red en Enfermedades Respiratorias (CIBERES)
5Institut de Salut Global de Barcelona (ISGlobal) de Recerca en Salut Internacional de Barcelona (CRESIB). Barcelona, Catalonia, Spain
6Centro de Investigación Biomédica En Red en Epidemiología y Salud Pública (CIBERESP)
7Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique

J Investig Allergol Clin Immunol 2021; Vol. 31(6)
doi: 10.18176/jiaci.0525

Background: Acute rhinosinusitis (ARS) have a high incidence in the general worldwide population. Although diagnosis is clinical and evolution is mostly self-limited, there is and overuse of diagnostic tools and medications by physicians which increases direct medical costs of disease.
Objective: The aim of the PROSINUS study was to quantify the direct medical costs of ARS management in Spain.
Methods: In a prospective observational study, 1,610 patients with clinical diagnosis of non-bacterial, non-complicated ARS in Spain were included. According to the duration of symptoms by EPOS, patients with ARS were classified as having viral or postviral ARS with different levels of severity. Direct medical costs were calculated according to medical visits, use of diagnostic tools, and prescribed medications.
Results: Overall, the direct medical costs per episode were €322.3±301.2 vs. €441.1±344.3 for viral and postviral ARS episodes respectively (p<0.001). When comparing viral vs. postviral, the medical costs per ARS episode were €245.0±265.4 vs. €328.4±301.9 (p<0.001) for medical visits, €38.1±64.0 vs. €61.9±78.8 (p<0.001) for diagnostic tools, and €39.2±25.9 vs. €50.8±25.3 (p<0.001), for prescribed medications.
Conclusions: The direct medical costs of post-viral ARS episodes were higher than viral (common cold). Non-complicated non-bacterial ARS represents an important socio-economical burden due to an excessive number of medical visits, use of diagnostic tools, and prescribed medications.

Key words: Acute rhinosinusitis. Common cold. EPOS. Direct costs. PROSINUS