Direct medical cost assessment in the <2 years-old hospitalized RSV+LRTI patients

Abstract

Objective: This multi-center study aimed to assess the direct medical costs in patients aged between 0-2 year-old admitted to the hospital due to lower respiratory tract infection (LRTI), which was identified as respiratory syncytial virus (RSV) in 3 big pediatric hospitals for a year.Material and Methods: During one-year period, <2-year-old LRTI patients with RSV+ and RSV- were included in the study conducted in 3 different pediatric hospitals. RSV was diagnosed with the detection of nasopharyngeal antigen. Direct medical costs (hospitalization, laboratory and treatment costs) were removed from the hospitals bills. Antibiotic costs of the antibiotic-treated cases were calculated independently. The indirect costs in the study were not considered and evaluated.Results: In the study, 10% of the total inpatients aged <2-years were hospitalized with LRTI. 38% (254/671) of patients with LRTI, 41% (151/368) of those with acute bronchiolitis and 34% (103/303) of those with pneumonia were RSV positive. 4% of all hospitalized cases were RSV+LRTI; nearly 88% of the RSV(+)LRTIs and 92% of RSV(-)LRTIs received antibiotics (p=0.09). 10% of the RSV(+)LRTIs and 13% of RSV(-)RLTIs were hospitalized in the intensive care units (p=0.19). It was found that the total direct medical hospitalization costs including the antibiotics including the RSV+LRTI median values were 334 (range: 6-21545) (mean+SD: 910 +/- 226) $, antibiotic costs median value was 24 (0-7691) (103 +/- 548) $, and non-antibiotic median value was 301 (6-18767) (789 +/- 1826) $. It was found that these values in the RSV-LRTI, on the other hand, 358 (5-31938) (1028 +/- 2741) $, 33 (0-33333) (90 +/- 236) $, 320 (5-31767) (911 +/- 2625) $ respectively. 48% of RSV+LRTI cases were aged between 0-3 months and it was found that the average cost per case was in this age group was two times higher than the 4-6 months and 7-11 months age group (on average 1068, 508 and 352$ respectively). It was found that the hospitalization costs of the total of 254 RSV+ patients were $ 231,178 and the costs of the 417 RSV- patients were $ 428,991.Conclusion: According to these results, RSV infections still constitute a significant part of RLTIs at <2 years of age in our country and cause an important epidemiological and economic disease burden.