Health Care Usage and Expenses Following Acute and Postacute Dengue Infection

Overview

This cohort study from Singapore analyzed health care utilization and costs among 55,870 adults with dengue compared to over 3 million controls. Dengue patients showed significantly increased risks and rates of emergency department visits, inpatient admissions, and hospitalization costs during both acute (0–30 days) and postacute (31–300 days) periods. Most excess costs occurred in the acute phase, but elevated health care use persisted up to 300 days post-infection.

Background

Dengue is a major vector-borne disease with a high global burden, especially in tropical low- and middle-income countries. While acute morbidity and mortality are well recognized, emerging evidence indicates that some dengue survivors experience chronic symptoms and new-onset sequelae similar to post-viral syndromes seen in infections like COVID-19. Understanding the long-term health care utilization and economic burden of dengue is critical for resource planning and patient management. Singapore, with endemic dengue and comprehensive national health databases, provides an ideal setting to quantify these outcomes.

Data Highlights

Key Findings

• Dengue patients had significantly elevated risks of emergency department visits and inpatient admissions during both acute and postacute periods compared to controls.
• Among those hospitalized, dengue patients experienced markedly higher rates of unique inpatient visits and substantially longer lengths of stay, especially in the acute phase.
• The majority of excess health care costs attributable to dengue occurred within the first 30 days post-infection, totaling over US$21 million.
• Excess health care utilization and costs persisted up to 300 days after infection, indicating ongoing postacute sequelae.
• Individuals with dengue were excluded if they had documented SARS-CoV-2 infection to isolate dengue-specific effects on health care use.

Clinical Implications

Clinicians should be aware that dengue infection can lead to prolonged health care needs beyond the acute illness, including increased hospital admissions and longer inpatient stays. Health systems, particularly in dengue-endemic regions, should anticipate and allocate resources for both acute management and postacute care to address ongoing sequelae. Early identification and monitoring of dengue survivors may help mitigate long-term complications and reduce health care burden.

Conclusion

This large population-based cohort study demonstrates that dengue infection results in significant excess health care utilization and costs extending up to 300 days post-infection. These findings highlight the importance of recognizing and managing postacute dengue sequelae to optimize patient outcomes and health system planning.

References

1. Tan et al. 2024 -- Health Care Usage and Expenses Following Acute and Postacute Dengue Infection: A Cohort Analysis Based on Population Data