Clinical Scorecard: Health Care Usage and Expenses Following Acute and Postacute Dengue Infection: A Cohort Analysis Based on Population Data
At a Glance
Category
Detail
Condition
Dengue infection with acute and postacute phases
Key Mechanisms
Increased health care utilization and costs due to acute infection and postacute sequelae
Target Population
Adults (≥18 years) in Singapore infected with dengue
Care Setting
Public hospitals and emergency departments in Singapore
Key Highlights
Dengue patients have elevated risk of emergency department visits, inpatient admissions, and inpatient costs during acute (0–30 days) and postacute (31–300 days) periods.
Among admitted patients, dengue infection is associated with significantly higher rates and longer lengths of inpatient and ICU stays compared to population controls.
Majority of excess health care costs occur during the acute phase (over US$21 million) compared to the postacute period (approximately US$687,000).
Guideline-Based Recommendations
Diagnosis
Confirm dengue infection using NS1 antigen assays or immunoglobulin M enzyme-linked immunoassay.
Report dengue cases to Ministry of Health within 24 hours of clinical diagnosis or laboratory confirmation.
Management
Monitor patients for acute symptoms and provide appropriate inpatient or ICU care as needed.
Recognize potential for postacute sequelae and plan follow-up care accordingly.
Monitoring & Follow-up
Track health care utilization including emergency department visits, hospital admissions, and ICU stays up to 300 days post-infection.
Exclude patients with SARS-CoV-2 infection within 300 days to avoid confounding long-term sequelae.
Risks
Increased risk of long-term health care utilization and costs due to postacute dengue sequelae.
Potential for multisystemic chronic symptoms similar to other viral infections.
Patient & Prescribing Data
Adults with laboratory-confirmed dengue infection in Singapore
Health care utilization and costs are substantially elevated in both acute and postacute phases, indicating need for resource planning and long-term patient monitoring.
Clinical Best Practices
Utilize national notification systems for timely dengue diagnosis and reporting.
Implement matched population controls for accurate assessment of dengue-related health care burden.
Plan health care resources to address both acute treatment and postacute sequelae management.
Exclude confounding infections such as COVID-19 when evaluating postinfectious sequelae.
by Jue Tao Lim, Liang En Wee, Wei Zhi Tan, Calvin Chiew, Lalitha Kurupatham, Cuiqin Poh, Nur-Afidah Md Suhaimi, Hui Zi Chua, Lee Ching Ng, Po Ying Chia, David Chien Boon Lye, Kelvin Bryan Tan
