Abstract
Introduction: Respiratory syncytial virus (RSV) bronchiolitis is among the leading causes of hospitalization in infants. Prophylaxis with palivizumab may reduce RSV infection, but its prescription is restricted to high-risk groups. The aim of the study is to retrospectively determine acute hospitalization costs of bronchiolitis.Materials and methods: Infants aged 1 month−1 year, admitted to Bambino Gesù Children Hospital, Rome, Italy, with a diagnosis of bronchiolitis from January 1 till December 31, 2017, were included in the study.Results: A total of 531 patients were enrolled in the study, and the mean age was 78.75 days. The main etiologic agent causing bronchiolitis was RSV, accounting for 58.38% of infections. The total cost of bronchiolitis hospitalization was 2,958,786 euros. The mean cost per patient was significantly higher in the case of RSV (5,753.43 ± 2,041.62 euros) compared to other etiology (5,395.15 ± 2,040.87 euros) (p = 0.04).Discussion: The study confirms the high hospitalization cost associated with bronchiolitis. In detail, in the case of RSV etiology, the cost was higher compared to other etiology, which is likely due to the longer hospitalization and the more frequent admission to the intensive cure department.Conclusion: This study highlights that bronchiolitis is an important cost item even in a tertiary hospital and that cost-effective interventions targeting RSV are increasingly urgent.
Highlights
Respiratory syncytial virus (RSV) bronchiolitis is among the leading causes of hospitalization in infants
Bronchiolitis is among the leading causes of hospitalization for infants, there are limited data concerning the epidemiology of bronchiolitis hospitalizations and the associated costs
The 2014 American Academy of Pediatrics clinical practice guideline on the diagnosis, management, and prevention of bronchiolitis describes bronchiolitis as “a constellation of signs and symptoms occurring in children younger than 2 years, including a viral upper respiratory tract prodrome followed by increased respiratory effort and wheezing” [11]
Summary
Respiratory syncytial virus (RSV) bronchiolitis is among the leading causes of hospitalization in infants. Prophylaxis with palivizumab may reduce RSV infection, but its prescription is restricted to high-risk groups. Respiratory syncytial virus (RSV) is the most common viral cause of bronchiolitis (70%), with 3.4 million admissions and about 199,000 deaths per year in predominantly resourced-limited countries [1, 2]. In Australia and New Zealand, a recent review reported a population-based increase in admissions to the intensive care unit for bronchiolitis, with associated increases in hospital costs [7]. Previous studies suggest an increase of RSV-related costs, with increased odds of subsequent wheezing, respiratory-related hospitalizations, and higher healthcare resource utilization [8, 9]. The prescription of palivizumab is restricted worldwide and in Italy is limited to the group of
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