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比利时呼吸道合胞病毒住院儿科患者护理成本评估:一项回顾性队列研究

Evaluation of the costs of care for pediatric patients hospitalized for RSV: A retrospective cohort study in Belgium.

作者信息

Tilmanne Anne, Pirson Magali, Leclercq Pol, Van Den Bulcke Julie, Dauvergne Jérôme E, Bruyneel Arnaud

机构信息

Infectious diseases and Infection Prevention and Control Department, CHU Tivoli, La Louviere, Belgium; Department of Infectious Diseases, Université libre de Bruxelles, Brussels, Belgium.

Health Economics, Hospital Management and Nursing Research Dept, School of Public Health, Université Libre de Bruxelles, Belgium.

出版信息

Vaccine. 2025 May 10;55:127065. doi: 10.1016/j.vaccine.2025.127065. Epub 2025 Mar 29.

Abstract

INTRODUCTION

This study aimed to evaluate the costs of respiratory-syncytial virus (RSV)-related hospitalizations in children under 3 years old in Belgium for hospitals and health insurance, and to identify factors influencing costs.

METHODS

This retrospective cohort study used data from 16 French-speaking hospitals in Belgium, covering January 1, 2018, to December 31, 2019. RSV diagnoses for children under three were identified using International Classification of Diseases-Tenth Revision (ICD-10) codes, resulting in 2176 hospitalizations analyzed for cost assessment. Hospital and health insurance costs were derived from administrative and billing data, adjusted for inflation, and analyzed using descriptive and inferential statistics, including regression models to assess cost factors.

RESULTS

Of the 2176 RSV-related hospitalizations, 61.8 % were in children under one year, and 74.1 % had readmissions within a year. The median length of stay (LOS) was 3.67 days, with a median hospital cost of €2924 and a median health insurance cost of €2221 per stay. Factors associated with higher costs included longer LOS, severe diagnosis-related group category, pediatric intensive care unit admission, and non-invasive ventilation use, with costs generally lower for children aged 1-2 years. Based on these data, the annual costs in Belgium associated with RSV hospitalizations in the pre-immunization era are estimated to exceed €26 million from the health insurance perspective and €29 million from the hospital perspective.

CONCLUSION

This study highlights the significant and underestimated financial burden of RSV hospitalization in Belgium. This emphasizes the need for better resource allocation to reduce the economic impact of RSV on healthcare systems.

摘要

引言

本研究旨在评估比利时3岁以下儿童因呼吸道合胞病毒(RSV)相关住院对医院和医疗保险造成的成本,并确定影响成本的因素。

方法

这项回顾性队列研究使用了比利时16家说法语医院的数据,涵盖2018年1月1日至2019年12月31日。通过国际疾病分类第十版(ICD-10)编码确定3岁以下儿童的RSV诊断,共分析了2176例住院病例以进行成本评估。医院和医疗保险成本来自行政和计费数据,进行了通货膨胀调整,并使用描述性和推断性统计方法进行分析,包括回归模型以评估成本因素。

结果

在2176例RSV相关住院病例中,61.8%为1岁以下儿童,74.1%在一年内再次入院。中位住院时间(LOS)为3.67天,每次住院的中位医院成本为2924欧元,中位医疗保险成本为2221欧元。与较高成本相关的因素包括住院时间更长、严重诊断相关组类别、儿科重症监护病房入院和使用无创通气,1-2岁儿童的成本通常较低。根据这些数据,从医疗保险角度估计,比利时在免疫接种前时代与RSV住院相关的年度成本超过2600万欧元,从医院角度估计超过2900万欧元。

结论

本研究强调了比利时RSV住院造成的巨大且被低估的财务负担。这凸显了更好地分配资源以减少RSV对医疗系统经济影响的必要性。

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