OBJECTIVES: To estimate the real-world financial burden concerning direct medical costs associated with Streptococcus suis (S.suis) treatment in Thailand and identify key drivers affecting high treatment costs under the healthcare sector perspective.

METHODS: A retrospective review of the 13-year data from 2005-2018 at Chiang Mai University Hospital was conducted. All patients’ records with confirmed positive S.suis would be included in the analyses. Patients’ characteristics, and direct medical costs were analyzed both descriptively and analytically. Multiple imputation with predictive mean matching was employed to deal with missing Glasgow Coma Score (GCS) data. Generalized linear models (GLMs) were used to forecast costs models and identify determinants of costs associated with S.suis treatment. The modified Park test was adopted to determine the appropriate family for healthcare costs. All costs were inflated and presented to 2019 value.

RESULTS: Among 130 S.suis patients, the mean age was 56.32±13.77 years. The average total direct medical cost was 12,4675 Thai baht (THB) (US$ 4,016), of which majority of expenses were from “others” category including room charges, staff services and medical devices. According to multivariate GLM analyses for costs, infective endocarditis (IE), GCS, length of stay, and bicarbonate level were significant predictors associated with high total treatment costs. Overall, marginal increases in IE and length of stay were significantly associated with increases in the total treatment costs (standard error) by 132,443 THB (39,638 THB) and 5,490 THB (1,715 THB), respectively whereas increases in GCS and bicarbonate level were associated with decreases in the total costs (standard error) by 13,118 THB (5,026 THB) and 7,497 THB (3,430 THB) respectively.

CONCLUSIONS: IE, GCS, length of stay, and bicarbonate level were significant cost drivers resulting in high treatment cost. Patients’ status at admission significantly impacts the outcomes and treatment costs. Early diagnosis and timely treatment were paramount to alleviate long-term complications and high healthcare expenditures.