749. Healthcare Utilization After Hospitalization for Respiratory Syncytial Virus or Unspecified Bronchiolitis in the First Year of Life

Abstract

BackgroundRespiratory syncytial virus (RSV) is the leading cause of infant hospitalizations and risk varies by gestational age (GA). Healthcare utilization following early hospitalizations caused by RSV (RSVH) or unspecified bronchiolitis (UBH) is not well understood. This study examined healthcare resource utilization (HRU) across GA categories within 12 months after an initial RSVH or UBH occurring in the first year of life.MethodsInfants born July 1, 2009 to June 30, 2015 were identified in the MarketScan Commercial (COM) and Multistate Medicaid (MED) databases and assigned to GA categories using DRG and ICD codes and to an initial hospitalization cohort using inpatient claim diagnosis codes (RSVH, UBH without RSVH, or COMP [a comparator without RSVH or UBH]). Index dates (first admission dates for hospitalized infants) were assigned to COMP infants using times from birth to index dates among RSVH infants. HRU (hospitalizations, outpatient pharmacy fills, and visits for emergency department [ED], urgent care, wellness, other office or outpatient) excluded index hospitalizations and was assessed from 14 days post-index (or discharge if later) through 12 months post-index. Results were propensity score weighted to balance pre-index characteristics (age, sex, region, GA, birth hospitalization characteristics) across cohorts. Proportions were compared with chi-squared tests.ResultsAmong all infants (all GA categories combined), the proportions of RSVH and UBH cohorts with follow-up hospitalizations or ED visits were greater (P < 0.05) than COMP (hospitalizations: COM +5.8%, +9.3%; MED +9.1%, +12.0%; ED visits: COM +15.8%, +16.2%; MED +14.4%, +17.1%). Follow-up hospitalizations in COM and MED and ED visits in COM declined with greater GA (Figures 1 and 2). HRU in other categories (fills, visits) was significantly (P < 0.05) greater among RSVH or UBH infants relative to COMP for nearly all GA categories in both COM and MED.ConclusionInfants hospitalized for RSV or UB in their first year of life had greater use of inpatient and outpatient resources in the 12 months following their initial hospitalizations compared with nonhospitalized infants. Inpatient care during follow-up was greatest among infants born at earlier GA.Funded by AstraZeneca Disclosures J. Ledbetter, AstraZeneca: Speaker’s Bureau, Speaker honorarium. L. Brannman, AstraZeneca: Employee, Salary and Stocks. S. Wade, Wade Outcomes Research and Consulting: Employee, Salary. D. Diakun, Truven Health Analytics, an IBM Company: Employee, Salary. T. Gonzales, AstraZeneca: Employee, Salary and Stocks. A. Kong, Truven Health Analytics, an IBM Company: Employee, Salary.