Pfizer Inc, New York, NY, USA.
HealthEcon Consulting, Inc, Ancaster, ON, Canada.
J Med Econ. 2022 Jan-Dec;25(1):334-346. doi: 10.1080/13696998.2022.2046401.
To describe the characteristics, healthcare resource use and costs associated with initial hospitalization and readmissions among pediatric patients with COVID-19 in the US.
Hospitalized pediatric patients, 0-11 years of age, with a primary or secondary discharge diagnosis code for COVID-19 (ICD-10 code U07.1) were selected from 1 April 2020 to 30 September 2021 in the US Premier Healthcare Database Special Release (PHD SR). Patient characteristics, hospital length of stay (LOS), in-hospital mortality, hospital costs, hospital charges, and COVID-19-associated readmission outcomes were evaluated and stratified by age groups (0-4, 5-11), four COVID-19 disease progression states based on intensive care unit (ICU) and invasive mechanical ventilation (IMV) usage, and three sequential calendar periods. Sensitivity analyses were performed using the US HealthVerity claims database and restricting the analyses to the primary discharge code.
Among 4,573 hospitalized pediatric patients aged 0-11 years, 68.0% were 0-4 years and 32.0% were 5-11 years, with a mean (median) age of 3.2 (1) years; 56.0% were male, and 67.2% were covered by Medicaid. Among the overall study population, 25.7% had immunocompromised condition(s), 23.1% were admitted to the ICU and 7.3% received IMV. The mean (median) hospital LOS was 4.3 (2) days, hospital costs and charges were $14,760 ($6,164) and $58,418 ($21,622), respectively; in-hospital mortality was 0.5%. LOS, costs, charges, and in-hospital mortality increased with ICU admission and/or IMV usage. In total, 2.1% had a COVID-19-associated readmission. Study outcomes appeared relatively more frequent and/or higher among those 5-11 than those 0-4. Results using the HealthVerity data source were generally consistent with main analyses.
This retrospective administrative database analysis relied on coding accuracy and inpatient admissions with validated hospital costs.
These findings underscore that children aged 0-11 years can experience severe COVID-19 illness requiring hospitalization and substantial hospital resource use, further supporting recommendations for COVID-19 vaccination.
描述美国儿童 COVID-19 患者初次住院和再入院的特征、医疗资源利用情况和相关费用。
在美国 Premier Healthcare Database Special Release（PHD SR）中，选择 2020 年 4 月 1 日至 2021 年 9 月 30 日期间，主要或次要出院诊断代码为 COVID-19（ICD-10 代码 U07.1）的 0-11 岁住院儿科患者。评估患者特征、住院时间（LOS）、院内死亡率、住院费用、住院费用和 COVID-19 相关再入院结局，并按年龄组（0-4 岁、5-11 岁）、基于 ICU 和有创机械通气（IMV）使用的 4 种 COVID-19 疾病进展状态和 3 个连续日历期进行分层。使用美国 HealthVerity 索赔数据库进行敏感性分析，并限制分析仅限于主要出院代码。
在 4573 名 0-11 岁住院儿科患者中，68.0%为 0-4 岁，32.0%为 5-11 岁，平均（中位数）年龄为 3.2（1）岁；56.0%为男性，67.2%由医疗补助覆盖。在整个研究人群中，25.7%有免疫功能低下的情况，23.1%被收治入 ICU，7.3%接受 IMV。平均（中位数）住院 LOS 为 4.3（2）天，住院费用和费用分别为 14760 美元（6164 美元）和 58418 美元（21622 美元）；院内死亡率为 0.5%。LOS、费用、费用和院内死亡率随 ICU 入院和/或 IMV 使用而增加。总共有 2.1%的患者发生 COVID-19 相关再入院。5-11 岁患者的研究结局似乎比 0-4 岁患者更频繁和/或更高。使用 HealthVerity 数据源的结果与主要分析基本一致。
这项回顾性的行政数据库分析依赖于编码的准确性和有验证的住院费用的住院入院。
这些发现强调，0-11 岁儿童可能会出现严重的 COVID-19 疾病，需要住院治疗和大量的医院资源，进一步支持 COVID-19 疫苗接种的建议。
