Respiratory outcomes, utilization and costs 12 months following a respiratory syncytial virus diagnosis among commercially insured late-preterm infants

Palmer, Liisa; Hall, Caroline Breese; Katkin, Julie P.; Shi, Nianwen; Masaquel, Anthony; McLaurin, Kimmie; Mahadevia, Parthiv J.

doi:10.1185/03007995.2010.542744

Cited by 26 publications

(26 citation statements)

References 23 publications

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“…The diagnostic codes used were consistent with those used in other administrative database studies. 24,33,[35][36][37][38][39][40][41][42] The RAMQ databases have been shown to have high sensitivity (97%) and specificity (92%) for identifying details of an individual's pregnancy and delivery, 43 to have high sensitivity (85%) and specificity (95%) for identifying individuals with asthma 44 and to differentiate between diagnoses of chronic obstructive pulmonary disease and asthma. 45 Although we did not find any specific assessments of the validity of ICD codes used to identify RDS, these codes are likely highly reliable as they would be provided by trained hospital nosologists with uniformity in coding from use of a common guideline to classify outcomes.…”

Section: Discussionmentioning

confidence: 98%

Respiratory Distress Syndrome at Birth Is a Risk Factor for Hospitalization for Lower Respiratory Tract Infections in Infancy

Szabo¹,

Gooch²,

Korol³

et al. 2012

Pediatric Infectious Disease Journal

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Section: Discussionmentioning

confidence: 98%

Respiratory Distress Syndrome at Birth Is a Risk Factor for Hospitalization for Lower Respiratory Tract Infections in Infancy

Szabo¹,

Gooch²,

Korol³

et al. 2012

Pediatric Infectious Disease Journal

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“…Although a relatively small time period, gaps of approximately 15 days would be expected to lead to significantly lower serum levels of palivizumab [23]. Results published by the Palivizumab Outcomes Registry Group [13] demonstrated similar results. The Registry study assessed compliance and RSV-related hospitalization rates in high-risk children receiving palivizumab at home vs. an outpatient setting; the investigators found significantly lower odds of an RSV-related hospitalization in infants receiving all doses within 35 days of previous dose compared with those who did not [16].…”

Section: Discussionmentioning

confidence: 99%

Association of RSV-related hospitalization and non-compliance with Palivizumab among commercially insured infants: a retrospective claims analysis

Stewart

Ryan²,

Seare

et al. 2013

BMC Infect Dis

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BackgroundPalivizumab has been shown to decrease the incidence of hospitalization due to respiratory syncytial virus (RSV) in infants at risk of severe RSV disease. We examined the association between compliance with palivizumab dosing throughout the RSV season and risk of RSV-related hospitalization in clinical practice.MethodsSubjects who were born and discharged from the hospital before the RSV season and received ≥1 palivizumab dose during their first RSV season were identified from a large US commercial health insurance database between 01/01/03 and 12/31/09. Subjects were deemed compliant if they received ≥5 palivizumab doses without gaps (>35 days) and their first dose was received by November 30. RSV-related hospitalizations were identified using ICD-9-CM diagnosis codes and examined over 2 observation periods: post-index dose and RSV season. A Cox proportional hazard model was used to evaluate the association between non-compliance and RSV-related hospitalization.ResultsOf the 5,003 subjects who received palivizumab, 62% were deemed non-compliant. Non-compliant subjects had significantly higher unadjusted rates of RSV-related hospitalizations compared to compliant subjects during both observation periods (post-index: 6.1 vs. 2.8 per 100 infant seasons, p < 0.001; RSV season: 5.9% vs. 2.3%; p < 0.001). In multivariate analyses, non-compliance was significantly associated with higher risk of RSV-related hospitalization (HR = 2.01; p < 0.001). Of the 225 RSV-related hospitalizations observed during the RSV season, 61 (27%) occurred before the first dose of palivizumab.ConclusionsSubjects who did not receive monthly dosing of palivizumab throughout the RSV season had significantly higher rates of RSV-related hospitalizations. The RSV-related hospitalizations prior to the first dose of palivizumab suggest some dosing was started too late.

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“…In those studies [2,3,5,7], RSV infection was confirmed by identifying RSV by immunofluorescence and/or positive culture from nasopharyngeal aspirates. RSV hospitalisation may also increase subsequent healthcare utilisation in infants born between 32 and 35 weeks of gestation [16,17,19]. In one study [19], however, the International Classification of Diseases was used and infants with probable as well as confirmed RSV hospitalisations were included.…”

Section: Introductionmentioning

confidence: 99%

RSV hospitalisation and healthcare utilisation in moderately prematurely born infants

et al. 2012

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Respiratory syncytial virus (RSV) infection is associated with chronic respiratory morbidity in infants born very prematurely. Our aims were to determine if infants born moderately prematurely (32--35 weeks of gestation) who had had an RSV hospitalisation, compared to those who had not, had greater healthcare utilisation and related cost of care in the first 2 years. Two thousand and sixty-six eligible infants' records were examined to identify three groups: 20 infants admitted for an RSV lower respiratory tract infection (RSV), 30 admitted for another respiratory problem (other respiratory) and 108 admitted for a nonrespiratory problem/never admitted (non-respiratory).Healthcare utilisation was assessed by examining hospital and general practitioner records and cost of care calculated using the National Scheme of Reference costs and the British National Formulary prices. The mean cost of care in the RSV group (£12,505) was greater than the non-respiratory(£1,178) (95% CI for difference £5,015 to £17,639, p=00.002) and the other respiratory (£3,356) groups (95% CI for difference £2,963 to £15,606, p<0.001). The adjusted mean differences in the cost of care were £11,186 between the RSV and non-respiratory groups (95% CI £4,763 to £17,609) and £9,076 (95% CI £2,515 to £15,637) between the RSV and the other respiratory groups. Forty-two of 2,066 eligible infants had an RSV hospitalisation (2%);thus, assuming prophylaxis would reduce the hospitalisation rate by 50%, the number needed to treat was 98. In conclusion,RSV hospitalisation in moderately prematurely born infants is associated with increased health-related cost of care. Nevertheless, if RSV prophylaxis is to be cost effective,a high risk group of moderately prematurely born infants needs to be identified.

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Respiratory outcomes, utilization and costs 12 months following a respiratory syncytial virus diagnosis among commercially insured late-preterm infants

Abstract: Commercially insured late-preterm infants with RSV infection are at high risk for recurrent wheezing and infantile asthma during the 1-year period after the initial episode and impose a significant economic burden to the healthcare system.

Cited by 26 publications

References 23 publications

Respiratory Distress Syndrome at Birth Is a Risk Factor for Hospitalization for Lower Respiratory Tract Infections in Infancy

Respiratory Distress Syndrome at Birth Is a Risk Factor for Hospitalization for Lower Respiratory Tract Infections in Infancy

Association of RSV-related hospitalization and non-compliance with Palivizumab among commercially insured infants: a retrospective claims analysis

RSV hospitalisation and healthcare utilisation in moderately prematurely born infants

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