Abstract
Background: Varicella is a common pediatric infection. Even if it generally has a benign course, it may complicate and require hospitalization. The aim of our study was to estimate the acute hospitalization cost (AHC) for varicella in the acute phase in a pediatric population. Methods: We calculated the AHC of pediatric patients admitted for varicella at Bambino Gesù Children Hospital, Rome, Italy, from 1 November 2005 to 1 November 2020. Results: In the study period, 825 pediatric patients affected by varicella were hospitalized. The mean hospitalization cost was EUR 4015.35 (range from EUR 558.44 to EUR 42,608.00). Among patients, 55% were unvaccinable due to either their age or their immunosuppression status. They would benefit from herd immunity, reducing the overall AHC by EUR 182,196,506. Since the introduction of the compulsory vaccination against varicella in Italy, we observed a significant reduction in AHC cost of 60.6% in 2019 and of 93.5% in 2020. Finally, from the beginning of the COVID-19 pandemic, we documented a decline of 81.2% and 76.9% in varicella hospitalization, compared to 2018 and 2019, respectively. Conclusions: Varicella AHC is an important economic and health assessment point and can be useful for improving preventive strategies.
Highlights
825 patients were hospitalized at Bambino Gesù Children Hospital for acute VZV disease
The objective of this research was to assess the economic burden of VZV and its complications in a third-level hospital in Italy in order to facilitate policy decision on the use of varicella immunization in Italy
As well as in Italy, other European Countries experienced sanitary costs connected to varicella hospitalization, ranging from EUR 61,399,804 to EUR 42,588,385 in annual cost, with a mean acute hospitalization cost (AHC) of EUR 2041 in England, EUR 1198.10 in Poland, and EUR
Summary
Varicella (VZV) is a preventable infectious disease which mainly affects the pediatric age. The most affected group is children aged 1 to 4 years [1]. Even if generally benign and self-limiting, varicella can be complicated by skin infection, pneumonia, encephalitis, cerebellar ataxia, arthritis, appendicitis, hepatitis, glomerulonephritis, pericarditis, and orchitis [3,4]. As a consequence, it may have a severe course, mainly in immunocompromised hosts. VZV may be prevented by a two-dose vaccine at 13–15 months of age and at 5–6 years [8]. As for Italy, we experienced a low coverage of 45.62%
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