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Rotavirus-associated hospitalization and emergency department costs and rotavirus vaccine program impact

机译：轮状病毒相关的住院和急诊部门费用以及轮状病毒疫苗计划的影响

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Objectives: To determine the medical costs of laboratory-confirmed rotavirus hospitalizations and emergency department (ED) visits and estimate the economic impact of the rotavirus vaccine program. Patients and methods: During 4 rotavirus seasons (2006-2009), children <3 years of age hospitalized or seen in the ED with laboratory-confirmed rotavirus were identified through active population-based rotavirus surveillance in three US counties. Medical costs were obtained from hospital and physician billing data, and factors associated with increased costs were examined. Annual national costs were estimated using rotavirus hospitalization and ED visit rates and medical costs for rotavirus hospitalizations and ED visits from our surveillance program for pre- (2006-2007) and post-vaccine (2008-2009) time periods. Results: Pre-vaccine, for hospitalizations, the median medical cost per child was $3581, the rotavirus hospitalization rate was 22.1/10,000, with an estimated annual national cost of $91 million. Post-vaccine, the median medical cost was $4304, the hospitalization rate was 6.3/10,000 and the estimated annual national cost was $31 million. Increased costs were associated with study site, age <3 months, underlying medical conditions and an atypical acute gastroenteritis presentation. For ED visits, the pre-vaccine median medical cost per child was $574, the ED visit rate was 291/10,000 resulting in an estimated annual national cost of $192 million. Post-vaccine, the median medical cost was $794, the ED visit rate was 71/10,000 with an estimated annual national cost of $65 million. Conclusions: After implementation of rotavirus immunization, the total annual medical costs decreased from $283 million to $96 million, an annual reduction of $187 million
机译：目标：确定实验室确认的轮状病毒住院治疗和急诊科（ED）的医疗费用，并估算轮状病毒疫苗计划的经济影响。患者和方法：在四个轮状病毒季节（2006-2009年）中，通过在美国三个县进行的基于人群的轮状病毒主动监测，确定了3岁以下住院或在急诊室就诊并经实验室确认的轮状病毒感染的儿童。从医院和医生的账单数据中获取医疗费用，并检查与费用增加相关的因素。根据轮状病毒住院和急诊就诊率以及轮状病毒住院和急诊就诊的医疗费用（根据我们在监测前（2006-2007年）和疫苗接种后（2008-2009年）的时间）估算的年度国家成本。结果：疫苗接种前，住院治疗的平均每个孩子的医疗费用为$ 3581，轮状病毒的住院率为22.1 / 10,000，估计每年的国家费用为$ 9,100万。疫苗接种后，医疗费用的中位数为$ 4304，住院率为6.3 / 10,000，全国每年的估计费用为$ 3,100万。成本增加与研究地点，年龄<3个月，基本医疗状况以及非典型急性胃肠炎表现有关。就急诊就诊而言，疫苗接种前每个孩子的医疗费用中位数为574美元，急诊就诊率为291 / 10,000，导致全国每年的估计费用为1.92亿美元。接种疫苗后，医疗费用的中位数为794美元，急诊就诊率为71 / 10,000，估计每年的国家医疗费用为6500万美元。结论：实施轮状病毒免疫后，年度医疗总费用从2.83亿美元减少到9600万美元，每年减少1.87亿美元。

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