Abstract
We described health resource utilization (HRU) among infants, young children and the elderly in a large clinical database. Using de-identified Optum Integrated claims and electronic medical records, we included patients experiencing their first RSV infection (ICD-9 diagnosis codes 480.1/079.6/466.11 and ICD-10 codes J12.2/B97.4/J21.0/J21.0/J20.5) between 01January 2008 and 31March 2015. We evaluated HRU attributable to RSV in terms of hospital cost (USD 2015), length of stay (LOS), ICU admissions, and we evaluated hospital ReAdmissions for Respiratory disease ≤30 days after discharge of hospitalization with RSV (RAR≤30). We included 12,959 patients with a first clinical diagnosis of RSV and at least one year of follow-up. 6,475 (50.0%) were infants/young children (0-5 years) without predefined pre-existing morbidities (WPPM) whilst 1,441 (11.1%) were infants/young children born pre-term, 954 (7.4%) were elderly (≥65 years). For infants/young children WPPM, the median LOS and cost per RSV hospitalization (N=722) was 4 days (IQR 3-5) and USD 7,683 (IQR 5,147-13,316). For pre-term infants/young children, the median LOS and cost per RSV hospitalization (N=282) was 5 days (IQR 3-7) and USD 10,501 (IQR 5,562-21,090). For elderly, the median LOS and cost per RSV hospitalization (N=219) was 8 days (IQR 5-22) and USD 14,070 (IQR 8,918-26,180). Excluding hospital births, 21.4%, 22.7% and 26.0% of RSV hospitalizations were ICU admissions for RSV among infants/young children WPPM, pre-term infants/young children and elderly, respectively. Median LOS in ICU was 2 days (IQR: 1-5) for infants/young children WPPM, 3 days (IQR: 2-5) for pre-term infants/young children and 6 for elderly (IQR: 4-13). The elderly had the highest frequency of RAR≤30 of 21 (9.6%) among RSV admissions. Median LOS for these respiratory readmissions was 11 days (IQR: 6-35) and cost was USD 11,577 (IQR: 5,067-19,790). RSV is associated with substantial hospital HRU in infants/young children, but there is also substantial hospital HRU in the elderly.
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