Comparative costs of hospitalisation among infants at high risk for respiratory syncytial virus lower respiratory tract infection during the first year of life

Abstract

Objective: This retrospective cohort study compared the total cost of hospitalisation due to respiratory syncytial virus (RSV) lower respiratory tract infection (LRI) during the first year of life between late-preterm (33–36 weeks gestational age [wGA]) and term (≥37 wGA) infants.

Research design and methods: A large national claims database of commercially insured members was examined to identify hospital admissions associated with RSV between January 2003 and June 2007 among infants at high risk for RSV LRI, including late-preterm infants. Hospital use and costs were compared with those of a reference cohort of term infants with RSV.

Results: The cost of hospitalisation for RSV among late-preterm infants with at least one hospital admission associated with RSV (n=173) was twice that of term infants (n=1,983; $20,269 vs. 9,635; p< 0.001). The mean length of stay was also higher (5.3 vs. 3.4 days; p< 0.001). Approximately 21.9% of hospitalisations for late-preterm infants included an intensive care unit admission compared with 9.6% among term infants (p< 0.001).

Limitations: Reliance on ICD-9 codes to identify potential cohort members may result in misclassification and underreporting the cohort size for conditions of interest.

Conclusions: Hospitalisation costs and length of stay due to RSV LRI were significantly greater among late-preterm infants compared with term infants and higher than general estimates previously reported in the broader paediatric population.

Key words::

• cost analysis
• hospitalisation
• length of stay
• premature infant
• respiratory
• syncytial virus infections
• viral bronchiolitis

Transparency

Declaration of funding: This study was funded by MedImmune, Gaithersburg, MD, USA.

Declaration of financial/other relationships: M.L.F., C.B.H. and A.J. have disclosed that they have served as consultants for MedImmune; C.B.H. has also received grant support from MedImmune. A.S.M. and P.J.M. have disclosed that they are employees of MedImmune.

The JME peer reviewer 1 and 2 have not received an honorarium for their review work on this manuscript. Peer reviewer 1 has disclosed that he is employed by and owns stock in Abbott Labs, Abbott Park, IL USA; reviewer 2 has disclosed that she has no relevant financial relationships.