Abstract
Background: Previous Swedish studies have shown a social gradient on paediatric care for viral gastroenteritis. Aim: To study the effect of a free rotavirus vaccine programme on hospital care for viral gastroenteritis. Method: A register-based national cohort study of paediatric in- and outpatient care for viral gastroenteritis in children <2 years old in two Swedish counties in 2014–2017, with the rest of the country as comparison. Adjusted hazard ratios were estimated by the differences-in-differences (DiD) estimator in Cox regression in the entire cohort and by social indicators. Results: Reductions of 37% and 24% for inpatient care, and 11 % and 21% for outpatient care for viral gastroenteritis were found in the Stockholm and Jönköping counties, respectively, after adjusting for time trends and social indicators. For inpatient care, the change was similar over social groups in both counties. In the larger county of Stockholm, smaller reductions in outpatient care were detected for children in socially disadvantaged families. Conclusions: A free rotavirus vaccination programme moderately reduced paediatric care for viral gastroenteritis. There were indications of an increase in socioeconomic differences in paediatric outpatient care for viral gastroenteritis, but further studies are needed to confirm this result in a broader health care perspective.
Highlights
IntroductionChildren from disadvantaged socioeconomic groups have a higher risk of poor health outcomes
Children from disadvantaged socioeconomic groups have a higher risk of poor health outcomes.This link is well documented, and has been shown in the context of paediatric care for viral gastrointestinal infections [1,2]
The pattern was similar in Jönköping county with reductions in paediatric care by Hazard ratios (HRs) 0.76 for inpatient care and HR 0.79 for outpatient care in comparison with the rest of Sweden, excluding
Summary
Children from disadvantaged socioeconomic groups have a higher risk of poor health outcomes. This link is well documented, and has been shown in the context of paediatric care for viral gastrointestinal infections [1,2]. Aim: To study the effect of a free rotavirus vaccine programme on hospital care for viral gastroenteritis. Results: Reductions of 37% and 24% for inpatient care, and 11 % and 21% for outpatient care for viral gastroenteritis were found in the Stockholm and Jönköping counties, respectively, after adjusting for time trends and social indicators. There were indications of an increase in socioeconomic differences in paediatric outpatient care for viral gastroenteritis, but further studies are needed to confirm this result in a broader health care perspective
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