Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 45 4 2016 04 27 423 434 María MORALES-SUÁREZ-VARELA Unit of Public Health, Hygiene and Environmental Health, Department of Preventive Medicine and Public Health, Food Science, Toxicology and Legal Medicine, University of Valencia, 46010 Valencia, Spain AND CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND Center for Public Health Research (CSISP-FISABIO), Valencia, Spain Agustín LLOPIS-GONZÁLEZ Unit of Public Health, Hygiene and Environmental Health, Department of Preventive Medicine and Public Health, Food Science, Toxicology and Legal Medicine, University of Valencia, 46010 Valencia, Spain AND CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND Center for Public Health Research (CSISP-FISABIO), Valencia, Spain Fernando GONZÁLEZ-CANDELA CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND Research Unit “Genomics and Health” CSISP-University of Valencia, Spain Jenaro ASTRAY Surveillance Branch, Community of Madrid, Spain Jordi ALONSO CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND University Pompeu Fabra, Barcelona, Spain AND Institute for Research IMIM-Hospital del Mar, Spain Olatz GARIN CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND University Pompeu Fabra, Barcelona, Spain AND Institute for Research IMIM-Hospital del Mar, Spain Ady CASTRO CIBER Epidemiologia y Salud Pública (CIBERESP), Spain Ramón y Cajal University Hospital, Madrid, Spain Juan Carlos GALAN CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND Ramón y Cajal University Hospital, Madrid, Spain Nuria SOLDEVILA CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND Public Health Institute of Navarra, Spain Jesús CASTILLA CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND Dept. of Health, Generalitat of Catalonia, Spain Pere GO­DOY CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND University of Jaen, Spain Miguel DELGADO-RODRÍGUEZ CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND University of León, Spain Vicente MARTIN CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND Security Service of Andalusia, Spain Jose María MAYORAL Red Española de Investigación en Patología Infecciosa (REIPI), Spain Tomas PUMAROLA CIBER Epidemiologia y Salud Pública (CIBERESP), Spain Basque Fundation for Health Innovation and Research, Spain José Maria QUINTANA CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND Basque Fundation for Health Innovation and Research, Spain Sonia TAMAMES Unit of Public Health, Hygiene and Environmental Health, Department of Preventive Medicine and Public Health, Food Science, Toxicology and Legal Medicine, University of Valencia, 46010 Valencia, Spain CIBER Epidemiologia y Salud Pública (CIBERESP), Spain Center for Public Health Research (CSISP-FISABIO), Valencia, Spain Nu­ria RUBIO-LÓPEZ Unit of Public Health, Hygiene and Environmental Health, Department of Preventive Medicine and Public Health, Food Science, Toxicology and Legal Medicine, University of Valencia, 46010 Valencia, Spain AND CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND Center for Public Health Research (CSISP-FISABIO), Valencia, Spain Angela DOMINGUEZ CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND Dept. of Public Health, University of Barcelona, Spain 2016 04 27 2016 04 27 Background: The healthcare and socio-economic burden resulting from influenza A (H1N1) pdm09 in Spain was considerable. Our aim was to estimate and compare the management (resource utilization) and economic healthcare impact in an at-risk group of unvaccinated pregnant women with an unvaccinated group of non-pregnant woman of childbearing age (15-44 yr old). Methods: We addressed this question with a longitudinal, observational, multicentre study. Inputs were the requirements in managing both groups of women. Outcome measures were healthcare costs. Direct healthcare (including medical utilisation, prescriptions of antivirals, medication, diagnostic tests, and hospitalisation) costs and indirect (productivity loss) costs were considered. Unit of cost was attributed to the frequency of health service resources utilisation. The mean cost per patient was calculated in this group of women. Results: We found that the influenza clinical pattern was worse in non-pregnant women as they had a high medical risk of 20.4% versus 6.1% of pregnant women. Non-pregnant required more antipyretics and antibiotics, and needed more health service resource utilisation (338 medical visits in non-pregnant women vs. 42 in pregnant women). The total cost of non-pregnant women was higher (€4,689.4/non-pregnant and €2,945.07/pregnant). Conclusions: Cost per (H1N1) pdm09 was lower for pregnant women, probably due to more preventive measures adopted for their protection in Spain. The highest costs were incurred by hospitalisations/day and work absenteeism for non-pregnant than for pregnant women. These data will allow better future pandemic influenza planning.     https://ijph.tums.ac.ir/index.php/ijph/article/view/6572 https://ijph.tums.ac.ir/index.php/ijph/article/download/6572/5348