Medical Costs of RSV-associated Hospitalizations and Emergency Department Visits in Children Aged <5 years: Observational Findings from the New Vaccine Surveillance Network (NVSN), 2016-2019.
Medical Costs of RSV-associated Hospitalizations and Emergency Department Visits in Children Aged <5 years: Observational Findings from the New Vaccine Surveillance Network (NVSN), 2016-2019.
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5 岁以下儿童与 RSV 相关的住院和急诊就诊的医疗费用：2016-2019 年新疫苗监测网络 (NVSN) 的观察结果。
DOI：
10.1016/j.jpeds.2024.114045
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
Klein,Eileen
中科院分区：
文献类型：
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作者：
Clopper,BenjaminR;Zhou,Yingtao;Tannis,Ayzsa;Staat,MaryAllen;Rice,Marilyn;Boom,JulieA;Sahni,LeilaC;Selvarangan,Rangaraj;Harrison,ChristopherJ;Halasa,NatashaB;Stewart,LauraS;Weinberg,GeoffreyA;Szilagyi,PeterG;Klein,Eileen
目的评估新疫苗监测网络纳入儿童呼吸道合胞病毒（RSV）病的住院和急诊医疗费用。研究设计：我们使用来自6个儿科卫生系统的会计和前瞻性监测数据，评估2016年至2019年5岁以下儿童中实验室确认的rsv相关住院（n= 2007）和急诊科就诊（n= 1267）的直接医疗成本。我们将费用分成与临床护理和行政计费实践相关的类别。我们使用描述性和双变量分析通过护理环境检查rsv相关的医疗费用。我们使用关联的卡方检验评估了已知RSV危险因素与住院费用和住院时间（LOS）之间的关联。结果每位住院儿童的平均费用为7,100美元（IQR: 4,006- 13,355美元），每次ED就诊的平均费用为503美元（IQR: 387- 930美元）。我们的最终样本中有80% （n= 2628）是小于2岁的儿童。较少的孕周（GA）与住院儿童较高的中位费用相关[p< 0.001，≥37周的GA: 6,840美元（3,905- 12,450美元）；29-36周GA: $7,721 ($4,362-$15,274)；< 29周GA: $9,131($4,518-$19,924)]。在我们的样本中，足月婴儿占总支出的70%。近四分之三的医疗保健支出来自12个月以下的儿童；推荐RSV预防措施针对的主要年龄组。结论减少幼儿呼吸道合胞病毒相关医疗保健的费用负担需要在所有幼儿中预防呼吸道合胞病毒，而不仅仅是高危婴儿。新获得的孕产妇疫苗和免疫预防产品可大大降低rsv相关的医疗费用。
ObjectiveTo assess medical costs of hospitalizations and emergency department (ED) care associated with respiratory syncytial virus (RSV) disease in children enrolled in the New Vaccine Surveillance Network.Study designWe used accounting and prospective surveillance data from six pediatric health systems to assess direct medical costs from laboratory-confirmed RSV-associated hospitalizations (n= 2,007) and ED visits (n= 1,267) from 2016 through 2019 among children aged< 5 years. We grouped costs into categories relevant to clinical care and administrative billing practices. We examined RSV-associated medical costs by care setting using descriptive and bivariate analyses. We assessed associations between known RSV risk factors and hospitalization costs and length of stay (LOS) using chi-square tests of association.ResultsThe median cost was $7,100 (IQR: $4,006-$13,355) per hospitalized child and $503 (IQR: $387-$930) per ED visit. Eighty percent (n= 2,628) of our final sample were children aged< 2 years. Fewer weeks' gestational age (GA) was associated with higher median costs in hospitalized children [p< 0.001,≥ 37 weeks' GA: $6,840 ($3,905-$12,450); 29-36 weeks' GA: $7,721 ($4,362-$15,274);< 29 w weeks' GA: $9,131 ($4,518-$19,924)]. Full-term infants accounted for 70% of the total expenditures in our sample. Almost three quarters of the healthcare dollars spent originated in children under 12 months of age; the primary age group targeted by recommended RSV prophylactics.ConclusionsReducing the cost burden for RSV-associated medical care in young children will require prevention of RSV in all young children, not just high-risk infants. Newly available maternal vaccine and immunoprophylaxis products could substantially reduce RSV-associated medical costs.