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The Annual Economic Burden of Syphilis: An Estimation of Direct, Productivity, and Intangible Costs for Syphilis in Guangdong Initiative for Comprehensive Control of Syphilis Sites

Zou, Yaming MM*; Liao, Yu PhD; Liu, Fengying MM; Chen, Lei MM; Shen, Hongcheng MPH; Huang, Shujie MM; Zheng, Heping MD; Yang, Bin MD; Hao, Yuantao PhD

doi: 10.1097/OLQ.0000000000000663
Original Studies

Background: Syphilis has continuously posed a great challenge to China. However, very little data existed regarding the cost of syphilis. Taking Guangdong Initiative for Comprehensive Control of Syphilis area as the research site, we aimed to comprehensively measure the annual economic burden of syphilis from a societal perspective.

Methods: Newly diagnosed and follow-up outpatient cases were investigated by questionnaire. Reported tertiary syphilis cases and medical institutions cost were both collected. The direct economic burden was measured by the bottom-up approach, the productivity cost by the human capital method, and the intangible burden by the contingency valuation method.

Results: Three hundred five valid early syphilis cases and 13 valid tertiary syphilis cases were collected in the investigation to estimate the personal average cost. The total economic burden of syphilis was US $729,096.85 in Guangdong Initiative for Comprehensive Control of Syphilis sites in the year of 2014, with medical institutions cost accounting for 73.23% of the total. Household average direct cost of early syphilis was US $23.74. Average hospitalization cost of tertiary syphilis was US $2,749.93. Of the cost to medical institutions, screening and testing comprised the largest proportion (26%), followed by intervention and case management (22%) and operational cost (21%). Household average productivity cost of early syphilis was US $61.19. Household intangible cost of syphilis was US $15,810.54.

Conclusions: Syphilis caused a substantial economic burden on patients, their families, and society in Guangdong. Household productivity and intangible costs both shared positive relationships with local economic levels. Strengthening the prevention and effective treatment of early syphilis could greatly help to lower the economic burden of syphilis.

This study showed that syphilis causes a substantial economic burden to patients, their families, and society, in which the direct cost of tertiary syphilis and intangible cost were huge.

From the *Department of Public Health, Wuxi Center for Disease Control and Prevention, Wuxi, China; †Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; and ‡Department of Sexually Transmitted Infections Control, Dermatology Hospital of Southern Medical University, Guangzhou, China

Acknowledgements: The authors would like to thank Fengying Liu, Lei Chen, Hongcheng Shen, Shujie Huang, Heping Zheng, and Bin Yang for their strong support and great help with the survey. The authors would like to thank all the doctors and nurses who made great efforts in data collection. The authors would also like to thank all the patients for their confidence and helpful cooperation.

Y.Z. and Y.L. were equal contributors.

Conflicts of Interest and Source of Funding: All authors declare that no conflict of interest exists in the submission of this manuscript. This research was supported by Medical Scientific Research Foundation of Guangdong Province, China (C2016021).

Y.Z. was responsible for developing the research protocol, guiding the field survey, doing the data analysis, and writing the first article. Y.L. revised and improved the draft and equally served as first author. Y.H. managed the funding for the research, and guided and reviewed the writing of the final article.

Correspondence: Yuantao Hao, PhD, Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Zhongshan Road 74, Guangzhou, China. E-mail: haoyt@mail.sysu.edu.cn, or Bin Yang, MD, Dermatology Hospital of Southern Medical University, Lujing Road 2, Guangzhou, China. E-mail: yangbin101@hotmail.com.

Received for publication January 8, 2017, and accepted May 15, 2017.

© Copyright 2017 American Sexually Transmitted Diseases Association