Original Articles
Respiratory syncytial virus pneumonia in the hospital setting: Length of stay, charges, and mortality,☆☆

https://doi.org/10.1067/mpd.2000.107525Get rights and content

Abstract

Background: Respiratory syncytial virus (RSV) is the most important viral cause of lower respiratory tract infection in infants and young children worldwide. No vaccine against RSV is available, but prophylactic interventions have been shown to be safe and effective in clinical trials. Objectives: This retrospective analysis was conducted to examine the health and economic burden of hospitalization for RSV pneumonia. Methods: Nationally weighted hospital discharges for RSV pneumonia among children 4 years old and younger were analyzed by using the Healthcare Cost and Utilization Project National Inpatient Sample. Results: In 1993, there were estimated to be 16,500 hospital discharges with RSV pneumonia, which increased to 19,700 and 20,800 in 1994 and 1995, respectively. Children less than 1 year of age accounted for over 70% of these discharges. Hospital charges (in 1998 dollars) for RSV pneumonia–associated episodes were $295,100,000 in 1993; $392,300,000 in 1994; and $295,800,000 in 1995. Conclusions: With inpatient charges of $300 to $400 million per year in the United States, the disease burden of RSV pneumonia is very high in terms of both morbidity and economic costs. Emerging prophylactic interventions should have an impact on the high burden of RSV pneumonia. (J Pediatr 2000;137:227-32)

Section snippets

Data Sources

The analysis was conducted by using the National Inpatient Sample from the Healthcare Cost and Utilization Project coordinated by the Agency for Health Care Policy and Research, releases 2, 3, and 4 for the years 1993, 1994, and 1995, respectively. This represented the most current data available. With approximately 6.5 million discharge records per year, the NIS represents approximately 20% of US hospitalizations. The NIS includes discharge weighting that enables national projections and the

Results

A total of 10,767 cases of RSV pneumonia were identified from the NIS sample as follows: 3161 records from 1993, 3658 records from 1994, and 3948 records from 1995. Cases with missing data were dropped from the analysis (9 cases were dropped from the length-of-stay analysis, 358 cases were dropped from the charges analysis, and 2 cases were dropped from the mortality analysis). After the application of the appropriate weights for the HCUP-3 data sets, a 1993 national weighted estimate of 16,500

Discussion

Our findings regarding the burden of RSV pneumonia are similar to the Institute of Medicine mortality estimates and the cost and hospitalization estimates made by the National Institute of Allergy and Infectious Diseases and the World Health Organization.7, 8 Our estimate may in fact be lower than the actual disease burden attributable to RSV, since we did not include RSV bronchiolitis in our analysis (because there was no code for such cases in the ICD-9 system until October 1, 1996). Shay et

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    Supported by a grant from MedImmune, Inc.

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