Clinical course and cost assessment of infants with a first episode of acute bronchiolitis presenting to the emergency department: Data from the GUERANDE clinical trial

Abstract

Introduction: Bronchiolitis is the leading cause of hospitalization for infants but its economic burden is not well documented. Our objective was to describe the clinical evolution and to assess the 1-month cost of a first episode of acute bronchiolitis presenting to the emergency department (ED).Methods: Our study was an epidemiologic analysis and a cost study of the cohort drawn from the clinical trial GUERANDE, conducted in 24 French pediatric EDs. Infants of 6 weeks to 12 months of age presenting at pediatric EDs with a first episode of bronchiolitis were eligible. The costs considered were collected from a societal viewpoint, according to the recommendations of the French National Health Authority.Results: A total of 777 infants were included with a median age of 4 months. A total of 57% were hospitalized during the month following the first consultation in the ED, including 28 (3.6%) in an intensive care unit. The mean length of stay was 4.2 days (SD = 3.7). The average time to relief of all symptoms was 13 days (SD = 7). Average total cost per patient was €1919 (95% confidence interval: 1756-2138) from a societal perspective, mostly due to hospitalization cost. The estimated annual cost of bronchiolitis in infants was evaluated to be between €160 and €273 million in France.Discussion: Bronchiolitis represent a high cost for the health care system and broadly for society, with hospitalizations costs being the main cost driver. Thus significant investments should be made to develop innovative therapies, to reduce the number of hospitalizations and length of stay.

Assessing the impact of COVID-19 on epidemiological changes of severe pediatric respiratory syncytial virus infections in Malaysia

“…Many studies have shown that the disease burden extends beyond affected children, impacting caregivers, leading to a loss of work productivity and increased hospitalization costs ( 17 ). Butel et al estimated an average total cost per patient of around EUR 2000 (equivalent to USD 2163) for the first episode of acute bronchiolitis, mainly attributed to hospitalization costs ( 18 ). Prior to COVID-19, RSV accounted for 5.4% of all detected positive respiratory pathogens in the United States between December 2019 and March 2020.…”

Families' costs form a considerable part of total costs in bronchiolitis care

“…The majority of the costs were due to hospitalization costs (€1418; 74%) and the rest were due to families' costs (€421; 22%) and due to employers (€80; 4%). 17 One German study including 77 hospitalized infants with bronchiolitis reported €81 costs for parents in 2005. 12 The study defined parental costs as a direct nonmedical cost that included supplemental childcare, transportation, absence from work, and additional expenses.…”

“…In a French study including 777 hospitalized infants with bronchiolitis, the average total cost for the society was €1919 per patient. The majority of the costs were due to hospitalization costs (€1418; 74%) and the rest were due to families' costs (€421; 22%) and due to employers (€80; 4%) 17 . One German study including 77 hospitalized infants with bronchiolitis reported €81 costs for parents in 2005 12 .…”

COVID-19 Lesson for Respiratory Syncytial Virus (RSV): Hygiene Works

“…Severe RSV disease is associated with caregiver loss of work productivity, increased hospitalization costs due to intensive care unit admission and ventilatory support, and long-term complications, including abnormal lung function, with bronchial hyper-responsiveness and recurrent wheezing [ 10 ]. Many studies have identified a substantial economic burden on healthcare systems, governments, and society [ 11 , 12 , 13 , 14 ].…”

“…In France, Butel and colleagues calculated an average total cost per patient of around EUR 2000 of a first episode of acute bronchiolitis, mostly due to hospitalization costs [ 11 ].…”