학술논문
The hidden costs and characteristics of childhood rotavirus emergency visits in Canada.
Document Type
Academic Journal
Author
Le Saux N; Department of Pediatrics, Children's Hospital of Eastern Ontario and CHEO Research Institute, Ottawa, Ontario, Canada. lesaux@cheo.on.ca; Bettinger J; Déry P; Embree J; Vaudry W; Halperin SA; McDermid A; Booth TF; Coyle D
Source
Publisher: Williams & Wilkins Country of Publication: United States NLM ID: 8701858 Publication Model: Print Cited Medium: Internet ISSN: 1532-0987 (Electronic) Linking ISSN: 08913668 NLM ISO Abbreviation: Pediatr Infect Dis J Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Administrative databases are often used to determine burden of rotavirus disease in emergency departments (EDs). Our objective was to describe rotavirus ED visits to include healthcare utilization pre- and postvisit to estimate true societal costs.
Methods: During rotavirus seasons in 2007, 2008, and 2009, a convenience sample of children <3 years of age with vomiting and/or diarrhea and rotavirus in stool samples at ED visits was identified at 5 pediatric hospitals in Canada. Interviews took place within 24 hours and 2 weeks after diagnosis, and ED charts were reviewed. Using unit costs for all resources, healthcare and societal costs were determined in Canadian dollars.
Results: A total of 199 children (mean age, 16 months; range, 1-35 months) had rotavirus and had a completed initial questionnaire on record. Prior healthcare provider visits had occurred in 104 (52.3%) before and 50/172 (29.1%) children 2 weeks after the ED visit. The mean healthcare cost of the ED visit alone was $218.10 (95% confidence interval [CI]: $198, $238), and the mean societal cost was $261.40 (95% CI: $240, $283). Including both total healthcare and parental costs, this increased to a mean total societal cost of $674.80 (95% CI: $578, $771) per episode of rotavirus infection.
Conclusions: Both the pre- and postvisit costs contribute substantially to the societal costs associated with an ED visit for rotavirus infection. In Canada, we estimate that the annual healthcare cost for children requiring a rotavirus ED visit ranges from $4.5 to $9.3 million, but when parental costs are included, the total societal cost ranges from $8.9 to $18.4 million.
Methods: During rotavirus seasons in 2007, 2008, and 2009, a convenience sample of children <3 years of age with vomiting and/or diarrhea and rotavirus in stool samples at ED visits was identified at 5 pediatric hospitals in Canada. Interviews took place within 24 hours and 2 weeks after diagnosis, and ED charts were reviewed. Using unit costs for all resources, healthcare and societal costs were determined in Canadian dollars.
Results: A total of 199 children (mean age, 16 months; range, 1-35 months) had rotavirus and had a completed initial questionnaire on record. Prior healthcare provider visits had occurred in 104 (52.3%) before and 50/172 (29.1%) children 2 weeks after the ED visit. The mean healthcare cost of the ED visit alone was $218.10 (95% confidence interval [CI]: $198, $238), and the mean societal cost was $261.40 (95% CI: $240, $283). Including both total healthcare and parental costs, this increased to a mean total societal cost of $674.80 (95% CI: $578, $771) per episode of rotavirus infection.
Conclusions: Both the pre- and postvisit costs contribute substantially to the societal costs associated with an ED visit for rotavirus infection. In Canada, we estimate that the annual healthcare cost for children requiring a rotavirus ED visit ranges from $4.5 to $9.3 million, but when parental costs are included, the total societal cost ranges from $8.9 to $18.4 million.