Costs In Spain Research Articles

Costs Analysis of Kidney Transplantation in Spain: Differences Between Regional Health Services

Background: For our society, chronic kidney disease is a major public health problem associated with high mortality, morbidity, reduced quality of life and a progressive increase in health costs. The aim of this study was to analyze and compare the current cost of kidney transplantation (KT) and kidney–pancreas transplantation (KPT) among the different Regional Health Services (RHS) in Spain. Methods: A descriptive comparative study analyzing the public prices of RHS in Spain. The Official Gazette of the different communities was consulted, where the latest available order on this type of cost was sought. A descriptive analysis was made of the stipulated cost of the KT and KPT, for each degree of severity, RHS, year of publication and cost calculation method. Mean cost and standard deviation were calculated. Results: KT prices were found for 15 of the 18 RHS (83.33%). The average cost of KT in Spain was €33,926.53 ± 6950.053 (range from €23,140.37 in the Canary Islands to €48,205.75 in Catalonia). For KPT, costs were found for 5 of the 18 RHS (27.8%). The mean cost of KPT was €65,792.38 ± 11,273.12 (ranging from €49,418.81 in Navarra to €78,363.20 in Andalusia). Conclusions: There is a large variability in KT and KPT costs in Spain between RHS. Our study underlines the importance of adopting standardized and updated costing methods for KT and KPT.

Healthcare and Epidemiological Surveillance Costs of Hepatitis A Outbreaks in Spain in Regions with and without Universal Hepatitis A Vaccination of Children during 2010-2018.

The aim of this study was to evaluate and compare hepatitis A outbreak-associated healthcare and epidemiological surveillance costs in Spain in two types of autonomous regions during 2010-2018: (1) regions with a prevention strategy based on universal hepatitis A vaccination of children and vaccination of high-risk population groups (Catalonia) and (2) regions with a prevention strategy based on vaccinating high-risk population groups (Castile and Leon, Murcia, Navarra, Community of Madrid, Community of Valencia). Healthcare costs were determined based on the resources used to treat hepatitis A outbreak-associated cases and hospitalizations. Epidemiological surveillance costs were calculated from the resources used during surveillance activities. The ratios for total, healthcare and epidemiological surveillance costs (regions without universal hepatitis A vaccination of children vs. Catalonia) were used to compare the two hepatitis A prevention strategies. From 2010 to 2018, the total, healthcare and epidemiological surveillance costs per million population were 1.75 times (EUR 101,671 vs. EUR 58,032), 1.96 times (EUR 75,500 vs. EUR 38,516) and 1.34 times greater (EUR 26,171 vs. EUR 19,515) in regions without universal hepatitis A vaccination of children than in Catalonia, respectively. The ratios tended to increase over time during 2010-2018. In 2015-2018, total, healthcare and epidemiological surveillance costs per million population were 2.68 times (EUR 69,993 vs. EUR 26,158), 2.86 times (EUR 53,807 vs. EUR 18,825) and 2.21 times greater (EUR 16,186 vs. EUR 7333) in regions without universal hepatitis A vaccination of children than in Catalonia, respectively. These findings suggest that universal hepatitis A vaccination of children could reduce hepatitis A outbreak-associated costs.

Global Perspectives in Acute Kidney Injury: Spain.

Global Perspectives in Acute Kidney Injury: Spain.

RWD149 Reduction in Ischemic Stroke Rates in Patients With Non-Valvular Atrial Fibrillation During the Period 2013-2020: A Real-Life Study in Spain

The aim of this study is to analyze the variations in the incidence of cardiovascular events and mortality rates in patients with non-valvular atrial fibrillation (NVAF) receiving antithrombotic treatment (VKA, NOAC or antiplatelet drugs) between 2013 and 2020. In addition, this study estimates the impact of these variations in the use of healthcare resources and costs in Spain.

How much does a forensic autopsy cost in Spain?

Introduction and objectivesThe autopsy is considered the gold standard in death investigation. Performing an autopsy requires human and material resources that must be programmed in order to meet the demands of the judicial system. However, as far as we know, the cost of forensic autopsy in Spain has not been determined. Thus, the aim of this study was to estimate the cost of a standard autopsy in order to organise Forensic Pathology Services more efficiently.Material and methodsA micro-cost analysis was carried out. The nominal group technique was applied using a panel of 10 forensic experts in order to identify and quantify the resources associated with a forensic autopsy.ResultsThe results showed that analysis and studies are the most important item in the total cost (54.7%), followed by staff (20.5%), preservation of body (14%), single-use products (7%), equipment and stock (1.6%), cleaning and disinfection (1.5%), facilities maintenance (0.5%) and IT (0.2%).ConclusionsThe total cost of a standard autopsy was €1501.45, which is lower than the European average. This study is the first in Spain to calculate the unit price of a forensic autopsy by means of micro-cost analysis. This may help to address the way forensic pathology centres are organised at different levels of complexity.

Hospital incidence and costs of congenital hydrocephalus in Spain: a multicenter retrospective study

Background Congenital hydrocephalus continues to represent a therapeutic challenge; however, few studies are available evaluating its hospital incidence and medical costs in Spain. This study aimed to review the profile of patients with this disorder admitted in Spanish hospitals and to estimate medical costs at the hospital level. Methods Records of hospital admissions of patients with congenital hydrocephalus between 2010 and 2019 were obtained from a Spanish hospital discharge database and analyzed in a retrospective multicenter study. Results A third of the patients included in the study were perinatal patients, however, the hospitalization rate in this group was higher to that in patients over 1 year of age. Perinatal patients required more ICU admissions and longer hospital stays, with more frequent surgical interventions and mechanical ventilation. The mean medical cost associated to congenital hydrocephalus was €9610 per admission, with significantly higher costs found in perinatal patients. Conclusions This study provides novel data on the hospital costs of congenital hydrocephalus in Spain. The hospital medical costs of this disorder have decreased over the past decade for perinatal patients but not in those aged 1 year and older, which should be considered in upcoming healthcare plans and resource allocation decisions.

Achieving Lower LDL-C Levels After a Recent Myocardial Infarction Might Be Associated with Lower Healthcare Resource Use and Costs in Spain.

IntroductionThere is little evidence on the relationship between achieved low-density lipoprotein cholesterol (LDL-C) levels and costs in patients on lipid-lowering therapy (LLT). We described healthcare resource use and costs (direct and indirect) by achieved LDL-C in patients receiving LLT after a recent myocardial infarction (MI) in Spain.MethodsThis was a retrospective observational study of anonymized electronic medical records from seven regions in Spain (BIG-PAC® database; n = 1.9 million). Eligible patients were adults (≥ 18 years) hospitalized for an MI between January 2015 and December 2017, treated with a statin and/or ezetimibe, and having recorded LDL-C values at baseline and during follow-up. Healthcare resource use and direct and indirect costs (in 2018, €) were described by achieved LDL-C levels during a follow-up of 18 months.ResultsOf 6025 patients (mean age, 69.7 years; 77% male), only 11% achieved LDL-C goals as defined in the 2016 ESC/EAS guidelines (< 70 mg/dL), and just 1% reached the lower target (< 55 mg/dL) in the current 2019 guidelines. Achieving lower LDL-C levels translated to lower healthcare resource use and costs. Mean total (direct and indirect) costs ranged from €5044 for patients with LDL-C < 55 mg/dL to €7567 for patients with LDL-C ≥ 130 mg/dL.ConclusionVery few patients achieved recommended LDL-C goals despite using LLT. Achieving lower LDL-C levels after an MI might be associated with lower healthcare resource use and costs. Use of more intensive LLT, leading to greater reductions in LDL-C, could therefore be beneficial both from a clinical and an economic perspective.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12325-022-02187-1.

POSB385 Use of Healthcare Resources and Cost Associated Related to Juvenile Idiopathic Arthritis in Spain: The Itaca-or Real-World Study

Juvenile idiopathic arthritis (JIA) is a chronic disease that represent a considerable burden for healthcare systems. There is a lack of information regarding the JIA related costs in Spain and its consequences for patients and caregivers. The aim of the present study was to assess direct healthcare, indirect resources utilization and associated costs from moderate-severe JIA patients in real clinical practice in Spain.

Economic costs of invasive alien species in Spain

Economic assessments for invasive alien species (IAS) are an urgent requirement for informed decision-making, coordinating and motivating the allocation of economic and human resources for the management of IAS. We searched for economic costs of IAS occurring in Spain, by using the InvaCost database and requesting data to regional governments and national authorities, which resulted in over 3,000 cost entries. Considering only robust data (i.e. excluding extrapolated, potential (not-incurred or expected) and low reliability costs), economic costs in Spain were estimated at US$ 261 million (€ 232 million) from 1997 to 2022. There was an increase from US$ 4 million per year before 2000 to US$ 15 million per year in the last years (from € 4 to 13 million). Robust data showed that most reported costs of IAS in Spain (&amp;gt; 90%) corresponded to management costs, while damage costs were only found for 2 out of the 174 species with reported costs. Economic costs relied mostly on regional and inter-regional administrations that spent 66% of costs in post-invasion management actions, contrary to all international guidelines, which recommend investing more in prevention. Regional administrations unequally reported costs. Moreover, 36% of the invasive species, reported to incur management costs, were not included in national or European regulations (i.e. Black Lists), suggesting the need to review these policies; besides, neighbouring regions seem to manage different groups of species. We suggest the need of a national lead agency to effectively coordinate actions, facilitate communication and collaboration amongst regional governments, national agencies and neighbouring countries. This will motivate the continuity of long-lasting management actions and the increase in efforts to report IAS costs by regional and inter-regional managers which will adequately provide information for future budgets gaining management effectiveness.

Long-Term Results and Cost-Effectiveness of the Flagida-Lite Regimen in Elderly Patients with Acute Myeloid Leukemia or High-Risk Myelodysplastic Syndrome

▪INTRODUCTIONAcute Myeloid Leukemia (AML) and high risk Myelodisplastic Syndrome (MDS) have a higher incidence in older patients. Due to their age, comorbidity and unfavorable biology of the disease, intensive chemotherapy offers poor results. Hypomethylating agents and other alternative regimens are being tested but the best strategy is currently not well defined.OBJECTIVEUpdating the FLAGIDA-lite intermediate intensity chemotherapy scheme results (Am J Hematol. 2012 Jan;87(1):42-4). Rate of overall response (OR), overall survival (OS) and treatment-related mortality (TRM) were evaluated. An estimated cost approach and a review of the 5-azacytidine cost estimation was made.PATIENTS AND METHODSSeventy patients older than 65 years with AML or high risk MDS treated with the FLAGIDA-lite regimen in three Spanish centers between 2006 and 2016 were analyzed. Median age was 76 years (IQL 73-81) and patients´ characteristics are shown in table 1 . The regimen consisted of: Fludarabine (40mg/m2 daily, days 1-5, P.O), Citarabine (20 mg/m2 daily, days 1-5, sub-Q) and Idarrubicin (15 mg/m2 daily, days 1-3, P.O until 2014, or IV 10 mg/m2 daily, days 1-3 when oral formulation disappeared). G-CSF (300 µg/24h sub-Q, days -1 to 5) was added except when leukocytosis was greater than 100,000/µl. Treatment administration and subsequent follow-up were performed under hospitalization, home care or ambulatory regimen. We calculated the regimen costs.RESULTSToxicity and Treatment Related MortalityA total of 117 chemotherapy cycles were administered (80 as induction and 37 as consolidation).Sixty-one (76.2%) induction and 34 (91.9%) consolidation cycles were administered under ambulatory or home care regimen; in 21 (34.4%) and 8 (21.6%) of them, respectively, hospital admission was necessary, mainly due to infectious complications.Thirteen (18.6%) patients died after induction, 10 due to treatment-related complications and 4 due to disease progression. Early mortality at 8 weeks was 20.9%. Treatment-related mortality was higher in patients older than 80 years (30 vs 10%), as shown in figure 1.Overall Response and Overall SurvivalSixty patients received one induction cycle and 10 received 2. OR rate was 64.9% (49.1% CR, 8.8% CRi; 7% PR) and 35.1% of patients were refractory. Median time to CR was 36 days (26-51). Twenty-six patients who had reached CR/CRi received consolidation with the same regimen (35 cycles) and 6 patients were submitted to a related allogeneic hematopoietic stem-cell transplantation.With a median follow-up of 23.8 months (9-105) in alive patients, estimated OS at 2 years was 22.6 (±5.4%) in the whole series and 41.1% (±9.4%) in patients who reached CR/CRi, as shown in figure 2. Median OS in patients who reached CR/CRi was significantly higher than in non-responder patients (17.4 vs 2.9 months, p< 0,001).Cost estimationThe cost of one cycle of FLAGIDA-lite, in Spain, is 1825.18 euros, as shown in table 2 . The median number of cycles administered in our study was 2, so the global cost of treatment drugs was 3650.36 euros. The estimated cost in Spain of another non-intensive regimen with not higher or similar efficacy (5-azacitidine) according to literature is 3028.14 euros each cycle and a total cost of 18,168.84 euros (median number of 6 cycles) . ( Health Econ Rev. 2013 Dec 5;3(1):28).CONCLUSIONFLAGIDA-lite is an effective alternative regimen in elderly patients with AML and high risk MDS, with low treatment-related mortality in patients younger than 80 years (10%) and with the possibility of an ambulatory management. This treatment offers an overall response rate around 65%, and an estimated overall survival at two years around 41% in responder patients. Its cost is markedly lower than the cost of 5-azacytidine. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Costs and healthcare utilisation of patients with chronic kidney disease in Spain

BackgroundData about the impact of chronic kidney disease (CKD) on health care costs in Spain are scarce This study was aimed to evaluate cumulative costs and healthcare utilisation in CKD in Spain.MethodsObservational, retrospective, population-based study, which included adults who received care for CKD between 2015 and 2019. Healthcare and medication costs were summarized on a yearly basis starting from the index date (1st January 2015), and then cumulatively until 2019.ResultsWe identified 44,214 patients with CKD (year 2015: age 76.4 ± 14.3 years, 49.0% women, albumin-to-creatinine ratio 362.9 ± 176.8 mg/g, estimated glomerular filtration rate 48.7 ± 13.2 mL/min/1.73 m2). During the 2015–2019 period, cumulative CKD associated costs reached 14,728.4 Euros, being cardiovascular disease hospitalizations, particularly due to heart failure and CKD, responsible for 77.1% of costs. Total medication cost accounted for 6.6% of the total cost. There was a progressive decrease in cardiovascular disease hospital costs per year (from 2741.1 Euros in 2015 to 1.971.7 Euros in 2019). This also occurred with cardiovascular and diabetic medication costs, as well as with the proportion of hospitalizations and mortality. Costs and healthcare resources use were higher in the DAPA-CKD like population, but also decreased over time.ConclusionsBetween 2015 and 2019, costs of patients with CKD in Spain were high, with cardiovascular hospitalizations as the key determinant. Medication costs were responsible for only a small proportion of total CKD costs. Improving CKD management, particularly with the use of cardiovascular and renal protective medications may be helpful to reduce CKD burden.

Improvements in high-speed rail network environmental evaluation and planning: An assessment of accessibility gains and landscape connectivity costs in Spain

High Speed Rail (HSR) in Spain began in 1992 and curently has a network of about 3400 km. In this 25-year period, accessibility has progressively increased, and its spatial distribution has changed throughout the territory. This has had important implications for territorial cohesion, which is a strategic planning objective of transport infrastructures in the European Union. However, this increase in HSR has environmental impacts; among other effects, new transport infrastructures imply a loss of landscape structural connectivity. This paper has two objectives: to study the distribution and development of the changes across the territory produced by the arrival of HSR in Spain between 1990 and 2025, by looking at changes in potential accessibility and structural habitat connectivity at the national scale; and to study – at the same scale – the relationship between both variables through the cost of accessibility improvements (socioeconomic variable) in terms of the loss of structural connectivity (environmental variable). All the analyses were done using GIS-based indicators, reported in the literature to be useful at the Strategic Environmental Assessment (SEA) scale. The methodology is applied in different horizon years, namely 1990, 2007, 2016, and new proposed HSR lines to 2025 in Spain. The results show that throughout the whole period (1990−2025), accessibility improved by 74.7 % due to the extension of HSR. The most important period was 1990−2007, when the main socio-economic centres were connected by HSR, while connectivity, the environmental variable, declined by −3.4 %. The greatest connectivity loss was concentrated in 2007−2016, when the areas with the highest connectivity values in 1990 were the most affected. Our results show that a 1 % increase in accessibility implied a loss of connectivity of 0.03 % in the interval 1990−2007, while in the second period, the same 1 % increase entailed a 0.17 % loss; in the 2016−2025 scenario the value is intermediate (0.08). Our work contributes to adapting connectivity studies to the environmental assessment tiers in the transportation sector (i.e. plans, programmes and projects). Each stage has its limitations due to the lack of specific data or problems of spatial scale which must be publicly reported during environmental assessment processes. We also highlight the need for new research to establish a reliable spatial scale to assess the different effects of HSR corridors at the strategic level.

Disease severity predicts higher healthcare costs among hospitalized nonalcoholic fatty liver disease/nonalcoholic steatohepatitis (NAFLD/NASH) patients in Spain.

The rising prevalence of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) presents many public health challenges, including a substantial impact on healthcare resource utilization and costs. There are important regional differences in the burden of NAFLD/NASH, and Spain-specific data are lacking. This retrospective, observational study examined the impact of liver disease severity, comorbidities, and demographics on healthcare resource utilization and costs in Spain.NAFLD/NASH patients in the Spanish National Health System's Hospital Discharge Records Database (1/1/2006 to 4/30/2017) were categorized into disease severity cohorts as NAFLD/NASH overall, NAFLD/NASH non-progressors, compensated cirrhosis (CC), decompensated cirrhosis (DCC), liver transplant (LT), or hepatocellular carcinoma (HCC). Patients were followed from index date until the earliest of 6 months, disease progression, end of coverage, death, or end of study. Within each cohort, pre- and post-index healthcare resource utilization and costs per patient per month (PPPM) were calculated.A total of 8,205 patients (mean age 58.4; 54% male) were identified; 5,984 (72.9%) were non-progressors, 139 (1.7%) progressed to CC, 2,028 (24.7%) to DCC, 115 (1.4%) to LT, and 61 (0.7%) to HCC. Pre-index comorbidity burden was high across disease cohorts, and the frequency of comorbidities increased with disease severity. From pre- to post-index, average length of stay (LOS) increased significantly (23%–41%) as did all-cause PPPM costs (44%–46%), with significantly longer LOS and costs in patients with increasing disease severity.Progression of NAFLD/NASH was associated with significantly higher costs and longer LOS. A coordinated approach is needed to manage resources and costs in Spain.

PND22 Discover Study, First Analysis Specific for Secondary Progressive Multiple Sclerosis Burden and Cost in Spain: Interim Analysis Results

PND22 Discover Study, First Analysis Specific for Secondary Progressive Multiple Sclerosis Burden and Cost in Spain: Interim Analysis Results

Thermodynamic and Cost Analysis of a Solar Dish Power Plant in Spain Hybridized with a Micro-Gas Turbine

Small-scale hybrid parabolic dish concentrated solar power systems are a promising option to obtain distributed electricity. During the day, solar energy is used to produce electricity, and the absence of sunlight can be overwhelmed with fuel combustion. This study presents a thermo-economic survey for a hybridized power plant in different regions of Spain, considering the local climatic conditions. The developed model considers the instant solar irradiance and ambient temperature dynamically, providing an estimation of the power output, the associated fuel consumption, and the most relevant pollutant emissions linked to combustion. Hybrid and combustion-only operating modes at selected geographical locations in Spain (with different latitudes, mean solar irradiances, and meteorological conditions) are analyzed. The levelized cost of electricity indicator is estimated as a function of investment, interest rate, maintenance, and fuel consumption actual costs in Spain. Values of about 124 €/MWhe are feasible. Fuel consumption and emissions in hybrid operation can be reduced above 30% with respect to those of the same turbine working in a pure combustion mode. This model shows the potential of hybrid solar dishes to become cost-competitive against non-renewable technologies from the point of view of costs and reduction in gas emission levels in regions with high solar radiation and low water resources.

Ixekizumab in psoriatic arthritis: more QALYs, lower cost in Spain

Ixekizumab in psoriatic arthritis: more QALYs, lower cost in Spain

Early ART improves outcomes at acceptable cost in Spain

Early ART improves outcomes at acceptable cost in Spain

Time and Cost of Hospitalisation for Salvage Therapy in Adults with Philadelphia Chromosome-Negative B Cell Precursor Relapsed or Refractory Acute Lymphoblastic Leukaemia in Spain.

BackgroundPhiladelphia chromosome-negative (Ph−) relapsed or refractory (R/R) B-cell precursor acute lymphoblastic leukaemia (ALL) is rare, and information on its impact on healthcare systems is scarce.ObjectiveTo quantify the time and reimbursement associated with hospitalisations of patients with R/R ALL in a Spanish hospital.MethodsRetrospective review of medical charts identified patients aged ≥ 18 years with Ph− R/R ALL hospitalised between 1998 and 2014. Data were collected from the date of first diagnosis of R/R ALL (index) until death or loss to follow-up. The primary endpoint was the proportion of time hospitalised during chemotherapy. Reimbursement associated with hospitalisations (including associated chemotherapy) was also assessed.ResultsThirty-two patients were eligible for inclusion. Their median age was 41 years, and 50% had a first remission duration of ≤ 1 year; 34% had undergone allogeneic haematological stem-cell transplantation (alloHSCT). Overall, 31 patients had received intensive salvage chemotherapy, during which there were 42 hospitalisations (mean 1.4/patient; mean duration 26 days). Patients spent a mean of 71% of the chemotherapy period in hospital. Total mean reimbursement was €26,417 per patient, almost all (€25,723) attributable to inpatient stays (€18,986/hospitalisation). From the index date to death or loss to follow-up (excluding alloHSCT-related hospitalisations), there were 80 hospitalisations (mean duration 24 days); mean reimbursement was €16,692 per hospitalisation and €41,730 per patient. AlloHSCT (n = 8) involved 18 hospitalisations (mean reimbursement €39,782/hospitalisation; €89,510/patient).ConclusionData from this sample of patients suggest that hospitalisations in R/R ALL are lengthy and associated with high costs in Spain.

Epidemiological trends of sepsis in the twenty-first century (2000\u20132013): an analysis of incidence, mortality, and associated costs in Spain

BackgroundSepsis has represented a substantial health care and economic burden worldwide during the previous several decades. Our aim was to analyze the epidemiological trends of hospital admissions, deaths, hospital resource expenditures, and associated costs related to sepsis during the twenty-first century in Spain.MethodsWe performed a retrospective study of all sepsis-related hospitalizations in Spanish public hospitals from 2000 to 2013. Data were obtained from records in the Minimum Basic Data Set. The outcome variables were sepsis, death, length of hospital stay (LOHS), and sepsis-associated costs. The study period was divided into three calendar periods (2000–2004, 2005–2009, and 2010–2013).ResultsOverall, 2,646,445 patients with sepsis were included, 485,685 of whom had died (18.4%). The incidence of sepsis (events per 1000 population) increased from 3.30 (2000–2004) to 4.28 (2005–2009) to 4.45 (2010–2013) (p < 0.001). The mortality rates from sepsis (deaths per 10,000 population) increased from 6.34 (2000–2004) to 7.88 (2005–2009) to 7.89 (2010–2013) (p < 0.001). The case fatality rate (CFR) or proportion of patients with sepsis who died decreased from 19.1% (2000–2004) to 18.4% (2005–2009) to 17.9% (2010–2013) (p < 0.001). The LOHS (days) decreased from 15.9 (2000–2004) to 15.7 (2005–2009) to 14.5 (2010–2013) (p < 0.001). Total and per patient hospital costs increased from 2000 to 2011, and then decreased by the impact of the economic crisis.ConclusionsSepsis has caused an increasing burden in terms of hospital admission, deaths, and costs in the Spanish public health system during the twenty-first century, but the incidence and mortality seemed to stabilize in 2010–2013. Moreover, there was a significant decrease in LOHS in 2010–2013 and a decline in hospital costs after 2011.

Impact of self-financed rotavirus vaccines on hospital stays and costs in Spain after a 3-year introductory period.

Vaccination has reduced rotavirus hospitalizations by 25% in European regions with low-moderate vaccine availability. We aimed to quantify the reduction in hospital costs after the longest period in which Rotarix® and Rotateq® were simultaneously commercially available in Spain. Cases, length of stay (LOS), and diagnosis-related groups (DRGs) were retrieved from the Minimum Basic Data Set. Healthcare expenditure was estimated through the cost accounting system Gescot®. DRGs were clustered: I, non-bacterial gastroenteritis with complications; II, without complications; III, requiring surgical/other procedures or neonatal cases (highest DRG weights). Comparisons between pre (2003-2005)- and post-vaccine (2007-2009) hospital stays and costs by DRG group were made. Rotaviruses were the most common agents of specific-coded gastroenteritis (N = 1657/5012). LOS and extended LOS of rotaviruses fell significantly in 2007-2009 (β-coefficient = -0·43, 95% confidence intervals (95% CI) -0·68 to -0·17; and odds ratio 0·62, 95% CI 0·50-0·76, respectively). Overall, costs attributable to rotavirus hospitalizations fell approximately €244 per patient (95% CI -365 to -123); the decrease in DRG group III was €2269 per patient (95% CI -4098 to -380). We concluded modest savings in hospital costs, largely attributable to cases with higher DRG weights, and a faster recovery. A universal rotavirus vaccination program deserves being re-evaluated, regarding its potential high impact on both at-risk children and societal costs.