Dervaux Benoit, Van Berleere Marine, Lenne Xavier, Wyckaert Marine, Dubos François
CHU Lille, Direction de la Recherche et de l'Innovation, Lille, France.
CHU Lille, Département d'Information Médicale, Lille, France.
Front Pediatr. 2023 Jul 14;11:1126229. doi: 10.3389/fped.2023.1126229. eCollection 2023.
In young children, respiratory syncytial virus (RSV)-related bronchiolitis is typically more severe than other respiratory tract infections, with a greater need for oxygen therapy and respiratory support. Few studies have compared the cost of hospitalization with regard to virological status. The objective of this study was to compare the costs of hospitalization for RSV-positive vs. RSV-negative bronchiolitis in a French university medical center between 2010 and 2015.
The cost models were compared using conventional goodness-of-fit criteria. Covariates included the characteristics of the patients, pre-existing respiratory and non-respiratory comorbidities, superinfections, medical care provided, and the length of stay.
RSV was detected in 679 (58.3%) of the 1,164 hospital stays by children under 2 years with virological data. Oxygen therapy and respiratory support were twice as frequent for the RSV-positive cases. The median hospitalization cost was estimated at €3,248.4 (interquartile range: €2,572.1). The cost distribution was positively skewed with a variation coefficient (CV = standard deviation/mean) greater than one (mean = €4,212.9, standard deviation = €5,047, CV = 1.2). In univariate analyses, there was no significant cost difference between the RSV-positive and RSV-negative cases. In the best multivariate model, the significant positive effect of RSV positivity on cost waned after the introduction of medical care variables and the length of stay. The results were sensitive to the specification of the model.
It was impossible to firmly conclude that hospitalization costs were higher for the RSV-positive cases.
在幼儿中，呼吸道合胞病毒（RSV）相关的细支气管炎通常比其他呼吸道感染更为严重，对氧疗和呼吸支持的需求更大。很少有研究比较过病毒学状态不同的住院费用。本研究的目的是比较2010年至2015年间法国一家大学医学中心RSV阳性与RSV阴性细支气管炎的住院费用。
使用传统的拟合优度标准比较成本模型。协变量包括患者特征、既往存在的呼吸和非呼吸合并症、重叠感染、所提供的医疗护理以及住院时间。
在1164例有病毒学数据的2岁以下儿童住院病例中，679例（58.3%）检测到RSV。RSV阳性病例的氧疗和呼吸支持频率是其他病例的两倍。住院费用中位数估计为3248.4欧元（四分位间距：2572.1欧元）。费用分布呈正偏态，变异系数（CV =标准差/均值）大于1（均值 = 4212.9欧元，标准差 = 5047欧元，CV = 1.2）。在单因素分析中，RSV阳性和RSV阴性病例之间的费用没有显著差异。在最佳多变量模型中，引入医疗护理变量和住院时间后，RSV阳性对费用的显著正向影响减弱。结果对模型的设定很敏感。
无法确切得出RSV阳性病例住院费用更高的结论。
