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高危幼儿呼吸道合胞病毒感染的预期住院费用。

Anticipated costs of hospitalization for respiratory syncytial virus infection in young children at risk.

作者信息

Rietveld Edwin, De Jonge Hendrik C C, Polder Johan J, Vergouwe Yvonne, Veeze Henk J, Moll Henriëtte A, Steyerberg Ewout W

机构信息

Department of Pediatrics, Erasmus MC-Sophia, Rotterdam, The Netherlands.

出版信息

Pediatr Infect Dis J. 2004 Jun;23(6):523-9. doi: 10.1097/01.inf.0000129690.35341.8d.

Abstract

BACKGROUND

Reliable estimates of hospitalization costs for severe respiratory syncytial virus (RSV) infection are necessary to perform economic analyses of preventive strategies of severe RSV disease. We aimed to develop a model that predicts anticipated mean RSV hospitalization costs of groups of young children at risk for hospitalization, but not yet hospitalized, based on readily available child characteristics.

METHODS

We determined real direct medical costs of RSV hospitalization from a societal perspective, using a bottom-up strategy, in 3458 infants and young children hospitalized for severe RSV disease during the RSV seasons 1996-1997 to 1999-2000 in the Southwest of the Netherlands. We used a linear regression model to predict anticipated mean RSV hospitalization costs of groups of children at risk, based on 4 child characteristics [age, gestational age, birth weight and bronchopulmonary dysplasia (BPD)], expressed in EC Euros as of the year 2000.

FINDINGS

The mean RSV hospitalization costs of all patients were 3110 Euros. RSV hospitalization costs were higher for patients with lower gestational age (5555 Euros; gestational age, </=28 weeks), lower birth weight (3895 Euros; birth weight </=2500 g), BPD (5785 Euros; with BPD) and young age (4730 Euros; first month of life). The linear regression model had an adjusted R of 0.08. This indicates a low explanatory ability for hospitalization costs of individual children. However, the model could accurately estimate the anticipated mean hospitalization costs of groups of children with the same characteristics.

INTERPRETATION

RSV hospitalization costs were substantial, especially of specific high risk groups. Anticipated mean hospitalization costs of groups of children at risk for RSV hospitalization, but not yet hospitalized, could well be estimated with 4 child characteristics (age, gestational age, birth weight and BPD). These estimated costs can be used for economic analyses of preventive strategies for severe RSV disease.

摘要

背景

为了对严重呼吸道合胞病毒(RSV)疾病的预防策略进行经济分析,有必要对严重RSV感染的住院费用进行可靠估算。我们旨在开发一种模型,该模型基于容易获得的儿童特征,预测有住院风险但尚未住院的幼儿群体预期的平均RSV住院费用。

方法

我们采用自下而上的策略,从社会角度确定了1996 - 1997年至1999 - 2000年荷兰西南部RSV流行季节期间3458例因严重RSV疾病住院的婴幼儿的RSV住院实际直接医疗费用。我们使用线性回归模型,根据4个儿童特征(年龄、胎龄、出生体重和支气管肺发育不良(BPD))预测有风险的儿童群体预期的平均RSV住院费用,费用以2000年的欧元表示。

结果

所有患者的平均RSV住院费用为3110欧元。胎龄较低(5555欧元;胎龄≤28周)、出生体重较低(3895欧元;出生体重≤2500克)、患有BPD(5785欧元;患有BPD)以及年龄较小(4730欧元;出生后第一个月)的患者的RSV住院费用更高。线性回归模型的调整R值为0.08。这表明该模型对个体儿童住院费用的解释能力较低。然而,该模型可以准确估算具有相同特征的儿童群体预期的平均住院费用。

解读

RSV住院费用相当可观,尤其是特定的高危群体。根据4个儿童特征(年龄、胎龄、出生体重和BPD)可以很好地估算有RSV住院风险但尚未住院的儿童群体预期的平均住院费用。这些估算费用可用于严重RSV疾病预防策略的经济分析。

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