Economic Burden of Medically Attended Respiratory Syncytial Virus Infections Among Privately Insured Children Under 5 Years of Age in the USA

IF 4.3 4区 医学 Q1 INFECTIOUS DISEASES
Phuong T. Tran, Sabina O. Nduaguba, Yanning Wang, Vakaramoko Diaby, Lynn Finelli, Yoonyoung Choi, Almut G. Winterstein
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Abstract

Background

The cost of medically attended RSV LRI (lower respiratory infection) is critical in determining the economic value of new RSV immunoprophylaxes. However, most studies have focused on intermittent RSV encounters, not the episode of care that captures the entirety of RSV illness.

Methods

We created age- and condition-specific cohorts of children under 5 years of age using MarketScan® data (2015–2019). We contrasted aggregating healthcare costs over RSV-LRTI episodes to ascertaining costs based on RSV-specific encounters only. Economic burden was estimated by multiplying costs per encounter or per episode by their respective incidence rates.

Results

Average cost was higher per episode than per encounter regardless of settings (inpatient: $28,586 vs. $18,056 and outpatient/ED: $2099 vs. $407 for infants). Across ages, the economic burden was highest for infants and RSV-LRTI requiring inpatient care, but the burden in outpatient/ED settings was disproportionately higher than costs due to higher incidence rates (for inpatient vs. outpatient episodes: $226,403 vs. $101,269; for inpatient vs. outpatient encounters: $151,878 vs. $38,819 per 1000 infant-years). For high-risk children, cost and burden were up to 3–10 times higher, respectively.

Conclusions

With a comprehensive stratification by settings and risk condition, the encounter- versus episode-based estimates provide a robust range for policymakers' economic appraisal of new RSV immunoprophylaxes.

Abstract Image

美国 5 岁以下私人保险儿童因呼吸道合胞病毒感染就医的经济负担。
背景:医疗护理 RSV LRI(下呼吸道感染)的成本对于确定新的 RSV 免疫预防措施的经济价值至关重要。然而,大多数研究关注的是间歇性的 RSV 就诊,而不是能够反映整个 RSV 疾病的护理过程:我们使用 MarketScan® 数据(2015-2019 年)创建了针对特定年龄和病情的 5 岁以下儿童队列。我们将RSV-LRTI病程的医疗成本与仅根据RSV特异性就诊确定的成本进行了对比。经济负担的估算方法是将每次就诊或每次发病的成本乘以各自的发病率:结果:无论在哪种情况下,每次发病的平均费用都高于每次就诊的平均费用(住院病人:28586 美元对 18056 美元,门诊/急诊病人:2099 美元对 407 美元)。在各年龄段中,需要住院治疗的婴儿和 RSV-LRTI 的经济负担最高,但由于发病率较高,门诊/急诊环境中的负担比成本高得不成比例(住院病人与门诊病人发病次数的对比:226,403 美元对 101,269 美元;住院病人与门诊病人就诊次数的对比:每千婴儿年 151,878 美元对 38,819 美元)。对于高风险儿童,成本和负担分别高出 3-10 倍:通过对环境和风险条件进行综合分层,基于就诊次数和就诊次数的估算结果为政策制定者对新的 RSV 免疫预防措施进行经济评估提供了一个可靠的范围。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
7.20
自引率
4.50%
发文量
120
审稿时长
6-12 weeks
期刊介绍: Influenza and Other Respiratory Viruses is the official journal of the International Society of Influenza and Other Respiratory Virus Diseases - an independent scientific professional society - dedicated to promoting the prevention, detection, treatment, and control of influenza and other respiratory virus diseases. Influenza and Other Respiratory Viruses is an Open Access journal. Copyright on any research article published by Influenza and Other Respiratory Viruses is retained by the author(s). Authors grant Wiley a license to publish the article and identify itself as the original publisher. Authors also grant any third party the right to use the article freely as long as its integrity is maintained and its original authors, citation details and publisher are identified.
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