Unintended Consequences Following the 2014 American Academy of Pediatrics Policy Change for Palivizumab Prophylaxis among Infants Born at Less than 29 Weeks' Gestation.
Unintended Consequences Following the 2014 American Academy of Pediatrics Policy Change for Palivizumab Prophylaxis among Infants Born at Less than 29 Weeks' Gestation.
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DOI：
10.1055/s-0040-1709127
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发表时间：
2021-08
影响因子：
2
通讯作者：
Ambrose CS
中科院分区：
文献类型：
--
作者：
Goldstein M;Krilov LR;Fergie J;Brannman L;Wade SW;Kong AM;Ambrose CS
目的比较2014年美国儿科学会政策变化前后29周胎龄儿与足月儿的呼吸道合胞病毒免疫预防门诊使用率和相对 住院率。研究设计 婴儿是在MarketScan商业和多州医疗补助数据库中确定的。2012年至2014年和2014年至2016年的门诊RSV IP收据和相对<；29 WGA/定期住院风险使用比率和差异模型进行评估。结果2014年后，商业和医疗补助人群以及医疗补助人群中3至6个月的婴儿和29周龄及3个月大的婴儿接受 门诊RSV免疫接种的人数有所下降。2014年后，婴儿和29周龄婴儿的相对RSVH风险在数字上更高，3个月大的婴儿和医疗补助婴儿的RSVH风险增加最多。差异性结果显示，在医疗补助保险人群中，29周龄的婴儿和足月儿(均为0至6个月的队列)患右室出血的相对风险显著增加(1.68，p = 0.0054)。在商业保险人群中也出现了类似幅度的非显著增长(1.57，p = 0.2867)。结论 2014年的政策变化与呼吸道合胞病毒IP使用量的减少和其他健康婴儿和29wga的RSVH风险增加有关。
Objective The aim of this study is to compare outpatient respiratory syncytial virus (RSV) immunoprophylaxis (IP) use and relative RSV hospitalization (RSVH) rates for infants <29 weeks' gestational age (wGA) versus term infants before and after the 2014 American Academy of Pediatrics (AAP) policy change. Study Design Infants were identified in the MarketScan Commercial and Multi-State Medicaid databases. Outpatient RSV IP receipt and relative <29 wGA/term hospitalization risks in 2012 to 2014 and 2014 to 2016 were assessed using rate ratios and a difference-in-difference model. Results Outpatient RSV IP receipt by infants <29 wGA and aged <3 months in the Commercial and Medicaid populations and those aged 3 to <6 months in the Medicaid population declined after 2014. Relative RSVH risks for infants <29 wGA were numerically greater after 2014, with infants aged <3 months and Medicaid infants experiencing the greatest increases. Difference-in-difference results indicated a significantly increased relative risk of RSVH for infants <29 wGA versus term (both cohorts aged 0 to <6 months) in the Medicaid-insured population (1.68, p = 0.0054). A nonsignificant increase of similar magnitude occurred in the commercially insured population (1.57, p = 0.2867). Conclusion The 2014 policy change was associated with a decrease in RSV IP use and an increase in RSVH risk among otherwise healthy infants <29 wGA.
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影响因子：
3.6
作者：
Bardach NS;Cabana MD
通讯作者：
Cabana MD
DOI：
10.1056/nejmoa0804877
发表时间：
2009-02-05
期刊：
The New England journal of medicine
影响因子：
--
作者：
Hall CB;Weinberg GA;Iwane MK;Blumkin AK;Edwards KM;Staat MA;Auinger P;Griffin MR;Poehling KA;Erdman D;Grijalva CG;Zhu Y;Szilagyi P
通讯作者：
Szilagyi P
影响因子：
2
作者：
Ambrose, Christopher S.
通讯作者：
Ambrose, Christopher S.
影响因子：
8
作者：
Ralston, Shawn L.;Lieberthal, Allan S.;Hernandez-Cancio, Sinsi
通讯作者：
Hernandez-Cancio, Sinsi
向美国急诊室呈现的婴儿中呼吸道合胞病毒的承认负担不足。
影响因子：
1.6
作者：
Makari D;Staat MA;Henrickson KJ;Wu X;Ambrose CS
通讯作者：
Ambrose CS