Department of Regulatory Science, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea.
Institute of Regulatory Innovation Through Science, Kyung Hee University, Seoul, 02447, Republic of Korea.
BMC Infect Dis. 2024 Oct 14;24(1):1152. doi: 10.1186/s12879-024-09971-0.
Respiratory syncytial virus (RSV) is the leading cause of severe respiratory infections in infants worldwide, significantly affecting their health and contributing to the global healthcare burden. We aimed to examine healthcare resource utilisation patterns and costs for infants under one year old with confirmed RSV infection across subgroups of different gestational ages and health conditions and the cost implications of RSV infections over time, thereby demonstrating the economic burden of the disease.
This retrospective cohort study utilised nationwide claims data from the Korea Health Insurance Review and Assessment Service for infants under one year of age with confirmed RSV infection in the first year of life from January 2017 to April 2022. The infants were stratified into three subgroups based on their gestational age and health status: unhealthy preterm, healthy preterm, and full-term infants. A descriptive analysis was conducted to estimate healthcare utilization by type of resource and costs related to the treatment of RSV.
Out of 93,585 RSV infections identified, 31,206 patients met the inclusion criteria; these included 963 unhealthy preterm, 1,768 healthy preterm and 28,475 full-term infants. In our study, 76.3% of the infants with confirmed RSV infection required intensive care, including hospitalisation and more critical interventions such as intensive care unit (ICU) or mechanical ventilation (MV). The total average cost of RSV management was notably higher for unhealthy preterm infants ($ 6,325; 95% confidence interval (CI): $ 5,484-7,165) than for healthy preterm ($ 1,134; 95% CI: $ 1,006 - 1,261) and full-term infants ($ 606; 95% CI: 583-630). Our findings confirmed a significant epidemiological and economic burden, with infants at greater risk-shorter gestational age and poorer health conditions. Furthermore, we observed a marked increase in the total average cost of RSV management during COVID-19, reflecting the complex interplay between RSV and pandemic-related healthcare dynamics.
Our findings provide evidence for the significant economic burden of RSV infection among infants, with considerable disparities based on gestational age and health status subgroups. However, RSV prevention policies should also recognise that healthy preterm or full-term infants who receive intensive care face a significant disease burden.
呼吸道合胞病毒（RSV）是全球导致婴儿严重呼吸道感染的主要原因，对其健康产生重大影响并导致全球医疗保健负担加重。我们旨在检查不同胎龄和健康状况的确诊 RSV 感染婴儿的医疗资源利用模式和成本，并随着时间的推移评估 RSV 感染的成本影响，从而展示疾病的经济负担。
本回顾性队列研究利用了全国性的韩国健康保险审查和评估服务的数据，该数据包括 2017 年 1 月至 2022 年 4 月期间一岁以下确诊 RSV 感染的婴儿。根据胎龄和健康状况，婴儿分为三个亚组：不健康早产儿、健康早产儿和足月婴儿。通过对资源类型和与 RSV 治疗相关的成本进行描述性分析来估计医疗保健的利用情况。
在确定的 93585 例 RSV 感染中，31206 例符合纳入标准，包括 963 例不健康早产儿、1768 例健康早产儿和 28475 例足月婴儿。在我们的研究中，76.3%的确诊 RSV 感染婴儿需要重症监护，包括住院治疗和更严重的干预措施，如重症监护病房（ICU）或机械通气（MV）。不健康早产儿的 RSV 管理总成本明显高于健康早产儿（6325 美元；95%置信区间（CI）：5484-7165 美元）和足月婴儿（606 美元；95%CI：583-630 美元）。我们的研究结果证实了 RSV 感染的显著流行病学和经济负担，具有更大风险的婴儿（胎龄较短和健康状况较差）。此外，我们观察到 COVID-19 期间 RSV 管理总成本的显著增加，这反映了 RSV 和与大流行相关的医疗动态之间的复杂相互作用。
我们的研究结果为 RSV 感染对婴儿造成的重大经济负担提供了证据，根据胎龄和健康状况亚组存在显著差异。然而，RSV 预防政策也应该认识到，接受重症监护的健康早产儿或足月婴儿面临着重大的疾病负担。
