Association of RSV lower respiratory tract infection and subsequent healthcare use and costs: a Medicaid claims analysis in early-preterm, late-preterm, and full-term infants

Shi, Nianwen; Palmer, Liisa; Chu, Bong-Chul; Katkin, Julie P.; Hall, Caroline Breese; Masaquel, Anthony; Mahadevia, Parthiv J.

doi:10.3111/13696998.2011.578188

Cited by 30 publications

(31 citation statements)

References 13 publications

(13 reference statements)

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“…Other studies, being even more specific in terms of procedures performed and assessed costs, were also carried out retrospectively . Significantly higher costs have been shown in children with risk factors of severe disease and RSV‐related complications; and also in early‐preterm and late‐preterm as compared to full term children who suffered an episode of bronchiolitis during their first year of life …”

Section: Introductionmentioning

confidence: 99%

“…20 Significantly higher costs have been shown in children with risk factors of severe disease and RSV-related complications; 13 and also in early-preterm and latepreterm as compared to full term children who suffered an episode of bronchiolitis during their first year of life. 21 With the availability of RSV prophylaxis (palivizumab), several prospective studies assessing its costeffectiveness have also estimated the economic burden of this condition and have compared the costs of children with or without prophylaxis. However, most of those studies have been performed in children with risk factors such as early prematurity, bronchopulmonary dysplasia, or other underlying diseases.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pediatricians' attitudes and costs of bronchiolitis in the emergency department: A prospective multicentre study

García‐Marcos

Valverde-Molina

Pavlovic-Nesic³

et al. 2013

Pediatric Pulmonology

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pediatricians' attitudes and costs of bronchiolitis in the emergency department: A prospective multicentre study

García‐Marcos

Valverde-Molina

Pavlovic-Nesic³

et al. 2013

Pediatric Pulmonology

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“…Interestingly, late preterm infants with a history of respiratory distress syndrome (RDS) had an increased risk (60 %) of LRTI-related hospitalization in infancy compared with those without RDS [24]. Healthcare use and costs within 1 year of a RSV-LRTI among Medicaid early-preterm and late-preterm infants compared with full-term infants revealed a significant burden in early-preterm and higher costs in late preterm compared to full-term infants [23].…”

Section: Introductionmentioning

confidence: 99%

Respiratory Syncytial Virus Associated Hospitalizations in Infants of 33 to 42 Weeksʼ Gestation: Does Gestational Age Matter?

et al. 2019

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Background To evaluate rates and characteristics of respiratory syncytial virus hospitalizations (RSV-H) in infants of 33 to 42 weeks of gestational age (GA). Patients All infants with a history of neonatal hospitalization and a GA of 33 to 42 weeks born between 2005 and 2015 and follow-up at least over one RSV season (first year of life). Infants with congenital heart disease and other congenital anomalies were excluded. Methods Retrospective single-center cohort STROBE compliant study. Data were collected regarding demographic data and re-hospitalization characteristics due to respiratory illness and due to RSV infection; and data were compared between moderate-late preterm, near term, term, and post term infants, respectively. Results A total of 81.656 live born infants were registered in our catchment area with gestational age from 33 to 42 weeks during the study period; and 2188 of 2356 preterm infants and 1004 of 1168 term infants with history of neonatal hospitalization were included for analysis. Rehospitalizations due to respiratory illness occurred in 301 preterm (13.8%) and 136 term (13.5%) infants for 381 and 183 times, respectively. In total 84 of 3192 infants (2.6%) were tested RSV positive, 61 of 2188 preterm (2.8%) and 23 of 1004 term (2.3%). Preterm infants without history of neonatal hospitalization had a RSV hospitalization (RSV-H) rate of 1.7% (61/3488) and term infants of 1.3% (967/74.644) that were significantly lower compared to study infants (p=0.004 and 0.002, respectively). Moderate and late preterm (2.8%), near term (3.1%) and post term (3.5%) infants had significantly higher RSV-H rates compared to term infants (1.2%). Risk factors for RSV-H in preterm infants included discharge during RSV season (4.2 vs. 2.0%, p=0.017) and presence of older siblings (4.2 vs. 2.1%, p=0.023), in term infants presence of older siblings (p=0.019). The course of RSV disease did not differ between groups. Discussion Interestingly, we did not observe decreasing RSV-H rates with increasing GA. Term infants represented the group with lowest RSV-H rates. Neonatal hospitalization was a risk factor for RSV-H for both preterm and term infants. Near term infants do more resemble the late preterm than term infants regarding RSV-H rates. Conclusion We found comparable higher RSV-H rates in all groups compared to term infants without differences in the course of disease and identified neonatal hospitalization as an independent risk factor.

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“…1 Neonatal and pediatric LRTIs and RSV are often mild, but can be associated with significant health resource utilization and result in an important burden on the patients, families, infrastructure, and budget of public healthcare systems [1]. Economic analyses indicate that substantial costs are associated with outpatient physician office and emergency department visits, but that a majority of the financial burden is accounted for by costs in inpatient hospital settings [2,3]. LRTI and RSV/LRTI hospitalization rates for all children <2 years of age vary between 0.5% and 2% [4].…”

Section: Introductionmentioning

confidence: 99%

“…LRTI and RSV/LRTI hospitalization rates for all children <2 years of age vary between 0.5% and 2% [4]. In comparison, LRTI, and particularly RSV specific LRTI, hospitalization rates and lengths of stay in infants and high-risk infants are substantially increased and associated with additional costs [3,4]. High-risk infants include early and late-preterm infants and those with bronchopulmonary dysplasia and congenital heart disease [3,5].…”

Section: Introductionmentioning

confidence: 99%

Acute care utilization due to hospitalizations for pediatric lower respiratory tract infections in British Columbia, Canada

Santibáñez

Gooch

et al. 2012

BMC Health Serv Res

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BackgroundPediatric LRTI hospitalizations are a significant burden on patients, families, and healthcare systems. This study determined the burden of pediatric LRTIs on hospital settings in British Columbia and the benefits of prevention strategies as they relate to healthcare resource demand.MethodsLRTI inpatient episodes for patients <19 years of age during 2008–2010 were extracted from the BC Discharge Abstract Database. The annual number of acute care beds required to treat pediatric LRTIs was estimated. Sub-analyses determined the burden due to infants <1 year of age and high-risk infants. Population projections were used to forecast LRTI hospitalizations and the effectiveness of public health initiatives to reduce the incidence of LRTIs to 2020 and 2030.ResultsDuring 2008–2010, LRTI as the primary diagnosis accounted for 32.0 and 75.9% hospitalizations for diseases of the respiratory system in children <19 years of age and infants <1 year of age, respectively. Infants <1 year of age accounted for 47 and 77% hospitalizations due to pediatric LRTIs and pediatric LRTI hospitalizations specifically due to respiratory syncytial virus (RSV), respectively. The average length of stay was 3.1 days for otherwise healthy infants <1 year of age and 9.1 days for high-risk infants (P <0.0001). 73.1% pediatric LRTI hospitalizations occurred between November and April. Over the study timeframe, 19.6 acute care beds were required on average to care for pediatric LRTIs which increased to 64.0 beds at the peak of LRTI hospitalizations. Increases in LRTI bed-days of 5.5 and 16.2% among <19 year olds by 2020 and 2030, respectively, were predicted. Implementation of appropriate prevention strategies could cause 307 and 338 less LRTI hospitalizations in <19 year olds in 2020 and 2030, respectively.ConclusionPediatric LRTI hospitalizations require significant use of acute care infrastructure particularly between November and April. Population projections show the burden may increase in the next 20 years, but implementation of effective public health prevention strategies may contribute to reducing the acute care demand and to supporting efforts for overall pediatric healthcare sustainability.

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Association of RSV lower respiratory tract infection and subsequent healthcare use and costs: a Medicaid claims analysis in early-preterm, late-preterm, and full-term infants

Abstract: The burden of RSV-LRI was substantial among early-preterm Medicaid infants. Costs were also higher among late-preterm relative to full-term infants.

Cited by 30 publications

References 13 publications

Pediatricians' attitudes and costs of bronchiolitis in the emergency department: A prospective multicentre study

Pediatricians' attitudes and costs of bronchiolitis in the emergency department: A prospective multicentre study

Respiratory Syncytial Virus Associated Hospitalizations in Infants of 33 to 42 Weeksʼ Gestation: Does Gestational Age Matter?

Acute care utilization due to hospitalizations for pediatric lower respiratory tract infections in British Columbia, Canada

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