A model of the costs of community and nosocomial pediatric respiratory syncytial virus infections in Canadian hospitals
- PMID: 24421788
- PMCID: PMC3630024
- DOI: 10.1155/2013/916769
A model of the costs of community and nosocomial pediatric respiratory syncytial virus infections in Canadian hospitals
Abstract
Background: Approximately one in 10 hospitalized patients will acquire a nosocomial infection (NI) after admission to hospital, of which 71% are due to respiratory viruses, including the respiratory syncytial virus (RSV). NIs are concerning and lead to prolonged hospitalizations. The economics of NIs are typically described in generalized terms and specific cost data are lacking.
Objective: To develop an evidence-based model for predicting the risk and cost of nosocomial RSV infection in pediatric settings.
Methods: A model was developed, from a Canadian perspective, to capture all costs related to an RSV infection hospitalization, including the risk and cost of an NI, diagnostic testing and infection control. All data inputs were derived from published literature. Deterministic sensitivity analyses were performed to evaluate the uncertainty associated with the estimates and to explore the impact of changes to key variables. A probabilistic sensitivity analysis was performed to estimate a confidence interval for the overall cost estimate.
Results: The estimated cost of nosocomial RSV infection adds approximately 30.5% to the hospitalization costs for the treatment of community-acquired severe RSV infection. The net benefits of the prevention activities were estimated to be equivalent to 9% of the total RSV-related costs. Changes in the estimated hospital infection transmission rates did not have a significant impact on the base-case estimate.
Conclusions: The risk and cost of nosocomial RSV infection contributes to the overall burden of RSV. The present model, which was developed to estimate this burden, can be adapted to other countries with different disease epidemiology, costs and hospital infection transmission rates.
Historique: Environ un patient hospitalisé sur dix contractera une infection d’origine nosocomiale (ION) après son hospitalisation, dont 71 % sont imputables à des virus respiratoires, y compris le virus respiratoire syncytial (VRS). Les ION sont inquiétantes et provoquent des hospitalisations prolongées. En général, les aspects économiques des ION sont décrits en termes généraux, et on ne possède pas de données précises sur leurs coûts.
Objectif: Élaborer un modèle fondé sur des données probantes pour prédire le risque et le coût des infections à VRS d’origine nosocomiale en milieu pédiatrique.
Méthodologie: Les chercheurs ont élaboré un modèle, d’après une perspective canadienne, afin de saisir tous les coûts liés à une hospitalisation découlant d’une infection à VRS, y compris le risque et le coût d’une ION, les tests diagnostiques et le contrôle de l’infection. Toutes les données saisies étaient dérivées des publications. Les chercheurs ont effectué des analyses de sensibilité déterministe pour évaluer l’incertitude associée aux évaluations et pour explorer les répercussions de changements aux variables clés. Ils ont effectué une analyse de sensibilité probabiliste pour évaluer l’intervalle de confiance de l’évaluation globale des coûts.
Résultats: Les coûts estimatifs de l’infection à VRS d’origine nosocomiale ajoutent environ 30,5 % aux frais d’hospitalisation pour traiter l’infection à VRS grave d’origine non nosocomiale. Les chercheurs ont évalué que les bénéfices nets des activités de prévention équivalaient à 9 % des coûts totaux liés au VRS. Les modifications aux taux estimatifs de transmission de l’infection en milieu hospitalier n’avaient pas de répercussions significatives sur l’évaluation des cas de base.
Conclusions: Le risque et le coût de l’infection à VRS d’origine nosocomiale contribuent au fardeau global du VRS. Le présent modèle, qui a été élaboré pour évaluer ce fardeau, peut être adapté à d’autres pays selon d’autres épidémiologies de maladies, coûts et taux de transmission de l’infection en milieu hospitalier.
Keywords: Nosocomial infection; Pediatrics; Respiratory syncytial virus.
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