Economic evaluation of community gastroenteritis

Dr Margaret Hellard
Dr Martha Sinclair
Prof Christopher Fairley (Melbourne University)
Mr A Harris (Centre for Health Evaluation, Monash University)
Mr Martyn Kirk (OzFoodNet, ANZFA)

Funded by: Cooperative Research Centre for Water Quality and Treatment

Gastroenteritis is an important illness that causes significant morbidity and mortality throughout the world. Worldwide, diarrhoeal diseases are thought to be the second most common cause of death after cardiac disease, and are the leading cause of childhood deaths. In Australia, compared to many developing countries there are relatively few deaths attributable to diarrhoeal illness or gastroenteritis: there have been on average 70 deaths per annum over a 5-year period in Australia. Despite this, gastroenteritis is believed to cause considerable morbidity due to it being a common illness.

Endemic gastroenteritis, as opposed to outbreaks, causes the greatest number of cases of gastroenteritis but information is limited about the extent of this illness, the resources required to manage it and the cost of these resources. The Department of Epidemiology and Preventive Medicine has recently completed data collection from a large community based study involving 2811 individuals (600 households) investigating the gastrointestinal health effects of drinking water (the Water Quality Study). The study was primarily designed to measure the amount of gastroenteritis attributable to drinking water but it also measured the rate of endemic gastroenteritis, the severity of illness, time taken off work and/or childcare, use of medication and consultations with doctors due to gastroenteritis.

The aim of this project was to measure the cost of community gastroenteritis. The medical and non-medical costs were measured and presented separately so the varying types of costs could be distinguished. The project also measured the cost of point of use water treatment units for households. The difference in the cost of gastroenteritis and water treatment units per individuals was calculated.

The total cost of endemic gastroenteritis in Australian was estimated to be $342,855,616. If the time costs and the time off work to care for a sick family member costs are removed the total cost of endemic gastroenteritis was estimated to be $69,248,278. Both costs are significant and highlight the impact of gastroenteritis on the community. The high costs also highlight the need for ongoing research to identify the main causes of endemic gastroenteritis. This will help in the development of risk management plans to reduce the burden of disease in a cost-effective way for the community.

Hellard ME, Sinclair MI, Harris AH, Kirk, M and Fairley CK (2003) The Cost of Community Gastroenteritis. Journal of Gastroenterology and Hepatology 18, 322-328.