Healthcare costs within a year of respiratory syncytial virus among medicaid infants

Abstract

Limited research exists on the economic impact of respiratory syncytial virus lower respiratory infection (RSV LRI) among vulnerable infant populations. This study evaluated healthcare costs of full-term and late-preterm Medicaid infants with RSV LRI within 1 year of infection. Medicaid administrative claims were used to conduct a retrospective study of infants born 2003-2005. Full-term and late-preterm infants <1 year old were assigned to groups based on RSV LRI and unspecified bronchiolitis/pneumonia (UBP) diagnosis codes and stratified by setting of diagnosis. Infants without evidence of RSV LRI/UBP were selected as a comparison group. Economic and clinical outcomes were analyzed descriptively using propensity score weighting, and logged ordinary least squares models were used to examine relationship between RSV and costs incurred within 1 year of infection. RSV LRI and UBP infants, regardless of gestational age or healthcare setting, were more likely to experience respiratory diagnoses of wheezing and infantile asthma versus comparisons. Adjusted and weighted healthcare costs were significantly higher for all groups of RSV LRI and UBP infants relative to comparison infants (P < 0.001). Among late-preterm infants with inpatient and outpatient RSV, marginal costs compared with controls were $17,465 and $2,158, respectively. Costs for RSV LRI and UBP Medicaid infants are substantial. While much of the costs result from initial RSV episodes, higher post-episode costs and rates of respiratory events, procedures, and medications in RSV and UBP infants versus comparisons indicate long-term economic impact from infection and the impact is greater among late-preterm compared to full-term infants.

Association of RSV-related hospitalization and non-compliance with Palivizumab among commercially insured infants: a retrospective claims analysis

“…The major outcome of interest was RSV-related hospitalizations, identified using RSV-specific diagnosis codes (079.6, 466.11, 480.1) and RSV-like diagnosis codes defined as unspecified bronchitis (466.0), bronchiolitis (466.19), viral pneumonia (480.9), bronchopneumonia (485), and pneumonia (486) that occurred during the RSV season [12-14]. RSV-like diagnoses were excluded if there were any claims for influenza or other bacterial pneumonia (481, 482.xx, 487.x) within 3 days of the RSV-like claim.…”

Respiratory syncytial virus hospitalization outcomes and costs of full-term and preterm infants

“…10, 11, 12 However, only one of these studies examined RSV hospitalization-specific outcomes, and none of the studies researched either preterm infant subgroups more specific than <33 wGA and 33–36 wGA or both publically and commercially insured populations. Therefore, the objective of this study was to provide contemporary and detailed information about the cost and severity of RSV hospitalizations among preterm and full-term Medicaid and commercially insured infants without CLD or other high-risk conditions.…”

Association of Late-Preterm Birth With Asthma in Young Children: Practice-Based Study

“…[2][3][4][5][6][7][8][9][10][11] Furthermore, there is evidence that, in the first year of life, late-preterm infants have a propensity for more severe illnesses and might require more medical services when hospitalized. [12][13][14] To date, however, the full magnitude of potential long-term morbidities for this population and their public health impact have not been well studied. The Eunice Kennedy Shriver National Institute of Child Health and Human Development has identified the economic impact and long-term health impact of late prematurity as priority areas of research.…”