{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T03:48:44Z","timestamp":1773287324684,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2019,1,21]],"date-time":"2019-01-21T00:00:00Z","timestamp":1548028800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000226","name":"Ontario Ministry of Health and Long-Term Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000226","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011094","name":"Public Health Agency of Canada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011094","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Zoonoses and Public Health"],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The objective of this study was to determine healthcare costs attributable to laboratory\u2010confirmed Lyme disease (LD) from the healthcare payer perspective in Ontario, Canada. A cost\u2010of\u2010illness study was conducted for incident LD subjects from 1 January 2006 through 31 December 2013 ascertained from provincial laboratory and reportable disease databases, linked to health administrative data. All LD subjects included were laboratory\u2010confirmed, according to provincial case definitions. Incident LD subjects were propensity\u2010score matched to uninfected subjects on age, sex, comorbidities and urban\/rural status. We used phase\u2010of\u2010care methods to calculate attributable costs for two phases of illness: initial care (\u226430\u00a0days following \u201cindex date\u201d) and continuing care (&gt;30\u00a0days after index date to the end of the follow\u2010up period). A total of 663 incident, confirmed LD subjects were identified from 2006 through 2013. Mean age was 44.2\u00a0\u00b1\u00a020.1\u00a0years; 339 (51.1%) were female; and 31 (4.7%) were hospitalized \u226430\u00a0days after index date. Six hundred fifty\u2010eight (99.2%) LD subjects were matched to uninfected subjects; mean follow\u2010up time was 3.3\u00a0years. Mean attributable costs per case during the initial care phase and continuing care were $277 (95% CI: $197, $357) and \u2212$5 (\u2212$27, $17), respectively. Attributable costs per LD subject aged 5\u201314\u00a0years were $440 ($132, $747), greater than the costs observed for other age strata. Expected 1\u2010year attributable costs were $832, given continuing care costs were negligible. Limitations to our study include estimating costs using a cohort of only laboratory\u2010confirmed LD cases, introducing selection bias for diagnosed and treated patients who may have a lower risk of developing sequelae. In conclusion, the initial care phase of LD is associated with increased healthcare costs, but without significant costs attributable to LD infection after 30\u00a0days. Estimates of costs attributable to LD are important for healthcare resource prioritization and the evaluation of novel interventions.<\/jats:p>","DOI":"10.1111\/zph.12560","type":"journal-article","created":{"date-parts":[[2019,1,22]],"date-time":"2019-01-22T01:33:25Z","timestamp":1548120805000},"page":"428-435","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Estimating direct healthcare costs attributable to laboratory\u2010confirmed Lyme disease in Ontario, Canada: A population\u2010based matched cohort study using health administrative data"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0006-3493","authenticated-orcid":false,"given":"Emily","family":"Shing","sequence":"first","affiliation":[{"name":"Public Health Ontario Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Wang","sequence":"additional","affiliation":[{"name":"Public Health Ontario Toronto Ontario Canada"},{"name":"Institute for Clinical Evaluative Sciences Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edwin","family":"Khoo","sequence":"additional","affiliation":[{"name":"Public Health Ontario Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2557-0897","authenticated-orcid":false,"given":"Gerald A.","family":"Evans","sequence":"additional","affiliation":[{"name":"Public Health Ontario Toronto Ontario Canada"},{"name":"Queens University Kingston Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Moore","sequence":"additional","affiliation":[{"name":"Public Health Ontario Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark P.","family":"Nelder","sequence":"additional","affiliation":[{"name":"Public Health Ontario Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9824-7623","authenticated-orcid":false,"given":"Samir N.","family":"Patel","sequence":"additional","affiliation":[{"name":"Public Health Ontario Toronto Ontario Canada"},{"name":"Public Health Ontario Laboratory Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Curtis","family":"Russell","sequence":"additional","affiliation":[{"name":"Public Health Ontario Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doug","family":"Sider","sequence":"additional","affiliation":[{"name":"Public Health Ontario Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2128-9133","authenticated-orcid":false,"given":"Beate","family":"Sander","sequence":"additional","affiliation":[{"name":"Public Health Ontario Toronto Ontario Canada"},{"name":"Institute for Clinical Evaluative Sciences Toronto Ontario Canada"},{"name":"Institute of Health Policy, Management and Evaluation University of Toronto Ontario Canada"},{"name":"University Health Network Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,1,21]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0116767"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/00273171.2011.568786"},{"key":"e_1_2_9_4_1","volume-title":"Lyme disease two\u2010step laboratory testing process","author":"CDC","year":"2015"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.14745\/ccdr.v43i10a01"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciu397"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0198509"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(20000215)19:3<335::AID-SIM336>3.0.CO;2-Z"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1155\/2010\/569692"},{"key":"e_1_2_9_10_1","volume-title":"Measuring rurality \u2010 Rurality index of Ontario 2008 basic: Methodology and results","author":"Kralj B.","year":"2009"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciq157"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1289\/EHP57"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1086\/324490"},{"key":"e_1_2_9_14_1","unstructured":"Ontario Ministry of Health and Long\u2010Term Care(2012).Health analyst\u2019s toolkit.Queen\u2019s Printer for Ontario.Retrieved fromhttp:\/\/www.health.gov.on.ca\/english\/providers\/pub\/healthanalytics\/health_toolkit\/health_toolkit.pdf. Accessed December 8 2017."},{"key":"e_1_2_9_15_1","volume-title":"Infectious diseases protocol","author":"Ontario Ministry of Health and Long\u2010Term Care","year":"2017"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss6622a1"},{"key":"e_1_2_9_17_1","unstructured":"Sider D. Patel S. Russell C. Jain\u2010Sheehan N. &Moore S.(2012).Technical report: Update on Lyme disease prevention and control. Retrieved fromhttp:\/\/www.publichealthontario.ca\/en\/eRepository\/PHO Technical Report - Update on Lyme Disease Prevention and Control Final 030212.pdf"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198908313210906"},{"key":"e_1_2_9_19_1","volume-title":"The Johns Hopkins ACG system","author":"The Johns Hopkins University.","year":"2013"},{"issue":"3","key":"e_1_2_9_20_1","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1093\/eurpub\/ckw269","article-title":"The cost of Lyme borreliosis","volume":"27","author":"Wijngaard C. C.","year":"2017","journal-title":"European Journal of Public Health"},{"key":"e_1_2_9_21_1","volume-title":"Guidelines on person\u2010level costing using administrative databases in Ontario","author":"Wodchis W. P.","year":"2013"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1086\/508667"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djn103"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1204.050602"}],"container-title":["Zoonoses and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fzph.12560","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/zph.12560","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/zph.12560","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/zph.12560","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,10]],"date-time":"2023-09-10T08:44:02Z","timestamp":1694335442000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/zph.12560"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,1,21]]},"references-count":23,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,6]]}},"alternative-id":["10.1111\/zph.12560"],"URL":"https:\/\/doi.org\/10.1111\/zph.12560","archive":["Portico"],"relation":{},"ISSN":["1863-1959","1863-2378"],"issn-type":[{"value":"1863-1959","type":"print"},{"value":"1863-2378","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,1,21]]},"assertion":[{"value":"2018-05-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-12-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-01-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}