Peer-reviewed article
Epidemiology and economic burden of medically attended influenza and influenza-like illness in Germany, 2016-2019.
Anna C Meyer, Julian Witte, Manuel Batram, José Bartelt-Hofer, Mathieu Bangert et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This epidemiological study describes influenza and influenza-like illness cases in Germany from 2016-2019 among insured individuals, focusing on older adults and people with underlying health conditions. The analysis found that while influenza incidence decreases with age, hospitalizations are most common among older adults, particularly those aged 80+. Direct healthcare costs ranged from €133 to €219 per case and were higher in older age groups and those with underlying conditions. The study is based on administrative health insurance claims data covering approximately 7 million people per season.
Key points
- One in five influenza cases in people aged 80+ years resulted in hospitalization
- Influenza/ILI incidence decreased with age, but older adults had the highest hospitalization rates
- Direct costs per case ranged from €133.28 to €218.99 and increased over the study period
- Individuals with underlying conditions had higher incidence of influenza/ILI and complications than those without
- The study likely underestimated total burden due to exclusion of cardiovascular and neurological complications
Limitations
The study does not report outcomes specifically for children as a primary population of interest, focusing instead on older adults and those with underlying conditions. Administrative claims data may underestimate true influenza burden due to underdiagnosis and misclassification, particularly in outpatient settings, and indirect costs such as productivity losses are not included.
Abstract
AIMS: Older adults and individuals with certain underlying conditions are at elevated risk of severe influenza complications. This study quantifies the burden of influenza and influenza-like illness (ILI) in Germany focusing on these high-risk groups. METHODS: This cohort study is based on claims data of a large statutory health insurance fund. Influenza/ILI was identified through International Classification of Diseases version 10 (ICD-10) codes J09-J11. Among insured individuals, the incidence of medically attended influenza/ILI, hospitalizations, complications, and direct healthcare costs were estimated for three consecutive influenza seasons from 2016-2017 to 2018-2019. Healthcare resource use, complications, and costs attributable to influenza were estimated through comparison with a matched control group. Analyses were stratified by age and prevalence of underlying conditions. RESULTS: Approximately 7 million individuals were included in each season. Influenza/ILI incidence decreased with age, but hospitalizations were most common among older adults. One in five cases aged 80+ years was hospitalized. In all age groups, individuals with underlying conditions had a higher incidence of influenza/ILI and of complications than those without underlying conditions. Direct costs per influenza/ILI case ranged from €133.28 (2016-2017) to €218.99 (2018-2019) and were higher in older adults and in individuals with underlying conditions. LIMITATIONS: Underdiagnosis and misclassification of influenza in administrative claims may occur, particularly in the outpatient setting. Only selected complications were examined; exclusion of cardiovascular and neurological consequences likely results in an underestimation of the influenza/ILI burden. Indirect costs, e.g. through productivity losses are not considered. CONCLUSIONS: Influenza/ILI significantly impacts the German healthcare system, with older adults and individuals with underlying conditions contributing disproportionately to the observed burden. Risks of severe outcomes and direct costs are highest in older adults, particularly those aged 80+ years, while children with underlying conditions also contribute substantially to the observed burden. These groups are important targets for preventive interventions.