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Medical Costs of Respiratory Syncytial Virus–Associated Hospitalizations and Emergency Department Visits in Children Aged Younger Than 5 Years: Observational Findings from the New Vaccine Surveillance Network, 2016-2019 - 09/07/24

Doi : 10.1016/j.jpeds.2024.114045 
Benjamin R. Clopper, MPH 1, , Yingtao Zhou, MPH 1, Ayzsa Tannis, MPH 1, Mary Allen Staat, MD, MPH 2, Marilyn Rice, MS 2, Julie A. Boom, MD 3, Leila C. Sahni, PhD, MPH 3, Rangaraj Selvarangan, PhD 4, Christopher J. Harrison, MD 5, 6, Natasha B. Halasa, MD, MPH 7, Laura S. Stewart, PhD 7, Geoffrey A. Weinberg, MD 8, Peter G. Szilagyi, MD, MPH 8, Eileen J. Klein, MD, MPH 9, Janet A. Englund, MD 9, Brian Rha, MD, MPH 10, Joana Y. Lively, MPH 10, Ismael R. Ortega-Sanchez, PhD 1, Meredith L. McMorrow, MD, MPH 1, 11, Heidi L. Moline, MD, MPH 1, 11
1 Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA 
2 Division of Infectious Diseases, Department of Pediatrics, University of Cincinnati, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 
3 Immunization Project, Texas Children’s Hospital and Department of Pediatrics, Baylor College of Medicine, Houston, TX 
4 Department of Pathology and Laboratory Medicine, Children’s Mercy Hospital, Kansas City, MO 
5 Department of Pediatrics, Children's Mercy Hospital, Kansas City, MO 
6 Department of Infectious Diseases, UMKC, Kansas City, MO 
7 Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN 
8 Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY 
9 Department of Pediatrics, University of Washington and Seattle Children’s Hospital, Seattle, WA 
10 Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, US Centers for Disease Control and Prevention, Atlanta, GA 
11 US Public Health Service, Rockville, MD 

Reprint requests: Benjamin R. Clopper, MPH, US Centers for Disease Control and Prevention, 1600 Clifton Rd. NE, Mailstop H24-9, Atlanta, GA 30333.US Centers for Disease Control and Prevention1600 Clifton Rd. NEMailstop H24-9AtlantaGA30333

Abstract

Objective

To assess medical costs of hospitalizations and emergency department (ED) care associated with respiratory syncytial virus (RSV) disease in children enrolled in the New Vaccine Surveillance Network.

Study design

We used accounting and prospective surveillance data from 6 pediatric health systems to assess direct medical costs from laboratory-confirmed RSV-associated hospitalizations (n = 2007) and ED visits (n = 1267) from 2016 through 2019 among children aged <5 years. We grouped costs into categories relevant to clinical care and administrative billing practices. We examined RSV-associated medical costs by care setting using descriptive and bivariate analyses. We assessed associations between known RSV risk factors and hospitalization costs and length of stay using χ2 tests of association.

Results

The median cost was $7100 (IQR $4006-$13 355) per hospitalized child and $503 (IQR $387-$930) per ED visit. Eighty percent (n = 2628) of our final sample were children aged younger than 2 years. Fewer weeks’ gestational age was associated with greater median costs in hospitalized children (P < .001, ≥37 weeks of gestational age: $6840 [$3905-$12 450]; 29-36 weeks of gestational age: $7721 [$4362-$15 274]; <29 weeks of gestational age: $9131 [$4518-$19 924]). Infants born full term accounted for 70% of the total expenditures in our sample. Almost three quarters of the health care dollars spent originated in children younger than 12 months of age, the primary age group targeted by recommended RSV prophylactics.

Conclusions

Reducing the cost burden for RSV-associated medical care in young children will require prevention of RSV in all young children, not just high-risk infants. Newly available maternal vaccine and immunoprophylaxis products could substantially reduce RSV-associated medical costs.

Le texte complet de cet article est disponible en PDF.

Keywords : RSV, cost, emergency department, hospitalizations, pediatrics

Abbreviations : ARI, ED, ICU, IPT, LOS, NVSN, RSV


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Article 114045- août 2024 Retour au numéro
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