Impact on affected families and society of severe rotavirus infections in Swedish children assessed in a prospective cohort study

Figures & data

Table 1. Unit costs and source.

Unit costs	Year 2015 (€)	Source
In-patient care for treatment of AGE/RVGE irrespective of length of hospital stay (DRG)	1866	National Board of Health and Welfare
Intensive care cost per day	4776	Stockholm county council
Emergency department visit	284	Stockholm county council
Primary care visit	140	Stockholm county council
Home visit by nurse	96	Stockholm county council
Telephone contact nurse	12	Rahmkvist, 1177 [32,33]
Consumables paid by families	–	Parents estimate
Reimbursement for transportation per km	0.2	Stockholm county council
Loss of production per full-time working day^a	301	Statistics Sweden [9]

AGE: acute gastroenteritis; RVGE: acute rotavirus gastroenteritis; DRG: diagnose related groups.

a Using the average cost of labour in 2008 according to the Labour Cost Survey (LCS) (converted to €301 per full-time working day 2015).

Figure 1. Overview of hospitalized children with acute gastroenteritis (AGE), with confirmed rotavirus excretion, and reasons for not being included in the study sample.

Figure 2. Age and gender distribution of children included in the study (n = 144).

Table 2. Socioeconomic parameters of parents to hospitalized children with laboratory confirmed rotavirus gastroenteritis (n = 144).

	Mothers	Fathers
Total number n (%)^a	144 (100)	138 (96)
Age, median (minimum–maximum)	33 (21–53)	35 (21–60)
Age, median (IQR)	33 (6.0)	35 (8.0)
Age, mean (SD), (95% CI)	33.3 (5.0), (32.5–34.1)	36.1 (6.5), (32.0–37.2)
Educational level
High-school degree, n (%)	42 (29)	51 (37)
University degree/and/or postgraduate training, n (%)	94 (65)	85 (62)
Parental allowance at the time of admission,^b n (%)	86 (60)	10 (7)
Working part-time at the time of admission,^b n (%)	24 (17)	11 (8)
Working full-time at the time of admission, n (%)	33 (23)	114 (83)

a Available to provide care for affected child.

b Parental allowance and part-time job are sometimes utilized in combination in Sweden.

n (%), number (percent) of parents with the specified characteristic; IQR: interquartile range; SD: standard deviation; CI: confidence interval.

Table 3. Utilization of health care, consumption of non-medical services and calculated average cost per child in the whole study (Euros (€) 2015).

	N = 144	Item		Total cost		Cost per family (€)
	n (%)	Mean (SD)	(95% CI)	€	% of totalsocietal cost	Mean (SD)	(95% CI)
Health care*
Before admission		Contacts
Visit to ED before visit leading to hospital admission	38 (26)	0.29 (0.51)	(0.21–0.38)	11,918	2.1	83 (146)	(59–107)
Visit primary care	26 (18)	0.22 (0.52)	(0.14–0.31)	4491	0.8	31 (73)	(19–43)
Home visit by nurse	1 (1)	0.01 (0.17)	(−0.01 to 0.04)	191	0.0	1 (16)	(−1 to 4)
Telephone contact, nurse	104 (72)	1.38 (1.24)	(1.17–1.58)	2417	0.4	17 (15)	(14–19)
Pharmaceuticals	70 (49)	–	–	625	0.1	4 (7)	(3–5)
Oral rehydration solution	92 (64)	–	–	930	0.2	6 (7)	(5–8)
Nutritional supplements	36 (25)	–	–	366	0.1	3 (7)	(1–4)
Total cost before admission				20,938	3.7	145 (181)	(116–175)
Hospital stay		Days
Infectious disease unit (DRG)	144 (100)	3.85 (2.20)	(3.49–4.22)	268,670	47.9	1866 (NA)	(NA)
Intensive care unit	2 (1)	0.03 (0.26)	(−0.02 to 0.07)	19,105	3.4	133 (1256)	(−74 to 340)
Total cost for inpatient care		3.88 (2.20)	(3.52–4.24)	287,775	51.3	1998 (1256)	(1792–2205)
After discharge		Visits
Visit to ED	12 (8)	0.10 (0.39)	(0.04–0.17)	2105	0.4	15 (54)	(6–24)
Pharmaceuticals	15 (10)	–	–	320	0.1	2 (11)	(−4)
Oral rehydration solution	26 (18)	–	–	227	0.0	2 (4)	(1–2)
Nutritional supplements	55 (38)	–	–	989	0.2	7 (25)	(3–11)
Total cost after discharge				3641	0.6	25 (65)	(15–36)
Total cost for health care				312,354	55.7	2169 (1253)	(1963–2376)
Non-medical cost accrued by families		km
Babysitting	6 (4)	–	–	1135	0.2	8 (55)	(−1 to 17)
Public transportation	36 (25)	–	–	2247	0.4	16 (61)	(6–26)
Private transportation	135 (94)	137 (144)	(113–160)	4083	0.7	28 (30)	(23–33)
Consumables**	136 (94)	–	–	7582	1.4	53 (93)	(37–68)
Total cost for non-medical services				15,047	2.7	104 (145)	(81–128)
Loss of productivity		Days
Absenteeism from work due to care of ill child	118 (82)	4.2 (3.8)	(4.5–5.8)	182,561	32.6	1268 (1189)	(1072–1464)
Absenteeism from work due to own illness	45 (31)	1.2 (2.2)	(0.8–1.5)	50,823	9.1	353 (667)	(243–463)
Total cost for loss of productivity				233,384	41.6	1621 (1387)	(1392–1849)
Total societal cost				560,786	100	3894 (1878)	(3585–4204)

a Unit costs: in-patient care DRG = €1866, intensive care day = €4776, ED visit = €284, visit primary care = €140, home visit by nurse = €96, telephone contact by nurse = €12, travel/km = €0.2, loss of production per full-time working day = €244. See Table 1 for the source of unit costs.

ED: emergency department; SD: standard deviation; CI: confidence interval; NA: not applicable.

Table 4. Working days lost by carers due to care of child or their own gastrointestinal symptoms: all families and families where both parents work full-time.

	Number of carers reporting loss of work days due to symptoms in child	Working days lost					Number of carers reporting loss of working days due to symptoms in the carer	Working days lost
			Affected families		All families				Affected families		All families
Carer	n (% of families)	Total days	Mean (SD)	95% CI	Mean (SD)	95% CI	n (% of families)	Total days	Mean (SD)	95% CI	Mean (SD)	95% CI
All families (N = 144)
Mother	49/144 (34)	227	4.6 (3.3)	3.7–5.6	1.6 (2.9)	1.1–2.1	5 (3)	20	4.0 (2.2)	2.0–6.0	0.1 (0.8)	0.0–0.3
Father	98/144 (68)	327	3.3 (1.9)	3.0–3.7	2.3 (2.2)	1.9–2.6	12 (8)	36	3.0 (1.4)	2.2–3.8	0.3 (0.9)	0.1–0.4
Other routine carer^a	24 (17)	54	2.2 (1.6)	1.6–2.9	0.4 (1.1)	0.2–0.5	30 (21)	113	3.8 (2.3)	2.9–4.6	0.8 (1.9)	0.5–1.1
All families	144	608			4.2 (4.0)	3.6–4.9	144	169			1.2 (2.2)	0.8–1.5
Families affected	118 (82)	608	5.1 (3.8)	4.5–5.8	–	–	45 (31)	169	3.8 (2.5)	3.0–4.5	–	–
	Number of carers reporting loss of working days due to symptoms in child	Working days lost					Number of carers reporting loss of working days due to symptoms in the carer	Working days lost
			Affected carer		All families with both parentsworking full-time				Affected carer		All families with bothparents working full-time
Carer	n (% of families)	Total days	Mean (SD)	95% CI	Mean (SD)	95% CI	n (% of families)	Total days lost	Mean (SD)	95% CI	Mean (SD)	95% CI
Families where both parents work full-time (N = 23)
Mother	22 (96)	109	4.9 (2.6)	3.9–6.0	4.7 (2.7)	3.6–5.8	3 (13)	14	4.7 (2.1)	2.3–7.0	0.6 (1.7)	−0.1 to 1.3
Father	20 (87)	69	3.5 (1.8)	2.7–4.2	3.0 (2.1)	2.2–3.8	1 (4)	5	5.0 (0.0)	5.0–5.0	0.2 (1.0)	−0.2 to 0.6
Other routine carer^a	5 (22)	11	2.2 (1.7)	0.7–3.6	0.5 (1.2)	0.0–0.9	5 (22)	17	3.4 (0.9)	2.6–4.2	0.7 (1.5)	0.1–1.3
All families with both parents working full-time	–	–	–	–	–	–	23	36			1.6 (2.8)	0.4–2.7
Families affected	23 (100)	189	8.2 (3.8)	6.7–9.8	8.2 (3.8)	6.7–9.8	8 (35)	36	4.5 (3.1)	2.3–6.7	–	–

a Commonly grandparents.

N: number; SD: standard deviation; CI: confidence interval.

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