Hospitalizations due to rotavirus gastroenteritis in Catalonia, Spain, 2003-2008

Abstract

BackgroundRotavirus is the most common cause of severe gastroenteritis among young children in Spain and worldwide. We evaluated hospitalizations due to community and hospital-acquired rotavirus gastroenteritis (RVGE) and estimated related costs in children under 5 years old in Catalonia, Spain.ResultsWe analyzed hospital discharge data from the Catalan Health Services regarding hospital admissions coded as infectious gastroenteritis in children under 5 for the period 2003-2008. In order to estimate admission incidence, we used population estimates for each study year published by the Statistic Institut of Catalonia (Idescat). The costs associated with hospital admissions due to rotavirus diarrhea were estimated for the same years. A decision tree model was used to estimate the threshold cost of rotavirus vaccine to achieve cost savings from the healthcare system perspective in Catalonia. From 2003 through 2008, 10655 children under 5 years old were admitted with infectious gastroenteritis (IGE). Twenty-two percent of these admissions were coded as RVGE, yielding an estimated average annual incidence of 104 RVGE hospitalizations per 100000 children in Catalonia. Eighty seven percent of admissions for RVGE occurred during December through March. The mean hospital stay was 3.7 days, 0.6 days longer than for other IGE. An additional 892 cases of presumed nosocomial RVGE were detected, yielding an incidence of 2.5 cases per 1000 child admissions. Total rotavirus hospitalization costs due to community acquired RVGE for the years 2003 and 2008 were 431,593 and 809,224 €, respectively. According to the estimated incidence and hospitalization costs, immunization would result in health system cost savings if the cost of the vaccine was 1.93 € or less. At a vaccine cost of 187 € the incremental cost per hospitalization prevented is 195,388 € (CI 95% 159,300; 238,400).ConclusionsThe burden of hospitalizations attributable to rotavirus appeared to be lower in Catalonia than in other regions of Spain and Europe. The relatively low incidence of hospitalization due to rotavirus makes rotavirus vaccination less cost-effective in Catalonia than in other areas with higher rotavirus disease burden.

Time series investigation of changes in seasonality of acute diarrhea hospitalizations before and after rotavirus vaccine in Southern Brazil

“…We found in this study the presence of an annual seasonality with spikes in the months of June or August depending on the region, but, both confirmed the results found in the literature with the largest rotavirus disease incidence in the cold and dry months 11,12,13,20,21 .…”

The effects of nosocomial rotavirus gastroenteritis on the length of hospital stay and cost

“…Studies have shown that rotavirus gastroenteritis is more frequent in the autumn and winter months [16,17]. Similarly, we found that rotavirus gastroenteritis was more frequent (77.5%) between October and March.…”

Decline in rotavirus hospitalizations following the first three years of vaccination in Castile-La Mancha, Spain

“…[24][25][26][27] The trend described in CLM resembles that noted for Spain as a whole. [10][11][12][13] 29,30 This means a 73% annual reduction of direct costs of RH. In European regions of low to moderate commercialization of the new vaccine, the reduction of IR under 2 y of age was 25-36% when comparing the periods 2008-11 and 2004-06, 31 similar to the decrease in Spain.…”

“…Despite these drugs are not subsidized by the government, recent studies have estimated a significant decrease in rotavirus hospitalizations in Spain since their use became more widespread in 2008. [10][11][12][13] Other industrialized countries have already shown a reduction in hospital admissions after 1 to 2 y of a complete immunization schedule, [14][15][16] with the vaccine remaining effective up to 3 y after the last dose. 17,18 The aim of our research is to describe the burden borne by hospitals due to community-acquired rotavirus in CLM and its …”