The economic burden of outpatient chlamydia infections in Southern China: a cross-sectional study, 2021-2023.

OBJECTIVE: The prevalence of chlamydia infections in China is rapidly increasing, which may lead to substantial economic burden. However, studies on the economic burden of chlamydia infections in China are limited. This study aims to measure the economic burden of outpatient chlamydia infections in Guangdong Province, China. DESIGN: Data on chlamydia outpatient costs were collected through outpatient medical record systems in healthcare facilities and a cross-sectional survey. SETTING: Outpatient departments of 15 hospitals in Guangdong Province, China. PARTICIPANTS: Patients diagnosed with chlamydia at the investigated medical institutions between 1 January 2021, and 31 December 2023. MAIN OUTCOME MEASURES: The direct economic burden (medical costs+non-medical costs) was assessed using a bottom-up approach, productivity loss was evaluated through the human capital approach and the intangible burden was assessed by the contingency valuation method. RESULTS: The annual per capita (per diagnosed outpatient case of chlamydia infection) medical costs were $37.74 (95% CI 35.38 to 40.10), with costs for patients with a co-diagnosis of pelvic inflammatory disease (PID) reaching $136.23 (95% CI 118.15 to 154.31). Annual per capita non-medical costs were $5.68 (95% CI 4.06 to 7.30) and productivity losses were $30.70 (95% CI 27.52 to 33.88). Ultimately, the per capita direct economic burden for outpatients with chlamydia was $43.42, and the total economic burden was $74.12. The per capita intangible cost was $132.49 (95% CI 110.12 to 154.86). Following the adjustment for covariates, medical costs were significantly associated with a co-diagnosis of PID (adjusted OR (aOR) = 8.07, 95% CI 5.23 to 12.31). The intangible cost was associated with urinary tract symptoms (aOR=1.56, 95% CI 1.01 to 2.42), abnormal vaginal bleeding (aOR=2.44, 95% CI 1.05 to 5.64), and high-risk sexual behaviour (aOR=5.63, 95% CI 1.63 to 17.63). CONCLUSION: In Southern China, chlamydia infections complicated by PID entail a markedly greater medical cost than uncomplicated infections. Effective prevention and treatment strategies are needed to prevent the progression of chlamydia infections to PID and thereby reduce the associated economic burden.