Evaluation of the costs of care for pediatric patients hospitalized for RSV: A retrospective cohort study in Belgium

Abstract

Introduction

This study aimed to evaluate the costs of respiratory-syncytial virus (RSV)-related hospitalizations in children under 3 years old in Belgium for hospitals and health insurance, and to identify factors influencing costs.

Methods

This retrospective cohort study used data from 16 French-speaking hospitals in Belgium, covering January 1, 2018, to December 31, 2019. RSV diagnoses for children under three were identified using International Classification of Diseases-Tenth Revision (ICD-10) codes, resulting in 2176 hospitalizations analyzed for cost assessment. Hospital and health insurance costs were derived from administrative and billing data, adjusted for inflation, and analyzed using descriptive and inferential statistics, including regression models to assess cost factors.

Results

Of the 2176 RSV-related hospitalizations, 61.8 % were in children under one year, and 74.1 % had readmissions within a year. The median length of stay (LOS) was 3.67 days, with a median hospital cost of €2924 and a median health insurance cost of €2221 per stay. Factors associated with higher costs included longer LOS, severe diagnosis-related group category, pediatric intensive care unit admission, and non-invasive ventilation use, with costs generally lower for children aged 1–2 years. Based on these data, the annual costs in Belgium associated with RSV hospitalizations in the pre-immunization era are estimated to exceed €26 million from the health insurance perspective and €29 million from the hospital perspective.

Conclusion

This study highlights the significant and underestimated financial burden of RSV hospitalization in Belgium. This emphasizes the need for better resource allocation to reduce the economic impact of RSV on healthcare systems.