Cost Burden of Severe Community-Acquired Rotavirus Gastroenteritis Requiring Hospitalization in the Czech Republic, Slovakia, Poland, and Hungary: A Retrospective Patient Chart Review

Abstract

Objectives: To provide valuable local data on the economic burden of rotavirus gastroenteritis (RVGE) for decision making on introduction of rotavirus vaccination in Central European countries.

Methods: We conducted a retrospective patient hospital chart review during the winter RVGE peak in the Czech Republic (n = 109), Hungary (n = 109), Poland, (n = 112), and Slovakia (n = 115) to estimate resource use and associated costs from the payer's perspective in children younger than 5 years with severe RVGE requiring hospitalization. Microcosting analysis was used to estimate the average costs of treating RVGE inpatients including pre- and posthospitalization costs.

Results: The average cost of treatment was €476, €316, €741, and €594 in the Czech Republic, Hungary, Poland, and Slovakia, respectively. Extrapolating these costs to the total number of RVGE hospitalizations gives annual cost estimates of €2.1 million, €1.5 million, €13.2 million, and €1.5 million, respectively. The main component of expenditure in all the four countries is the hospital stay, but wide variation among countries was observed (total cost of treating RVGE in hospital was almost 2.5-fold higher in Poland than in Hungary). In countries with diagnosis related group (DRG) costs available, the best agreement between real resource-use-driven costs and the DRG cost was found in the Czech Republic and Hungary, with differences of only €22 and €33, respectively. In Poland, the microcosting indicated higher overall costs incurred in hospital than the DRG cost, with a difference exceeding €190.

Conclusions: Hospitalization of children with RVGE represents a substantial economic burden for the national health systems in these countries.

Keywords: Visegrad region; chart review; cost burden; incidence; rotavirus gastroenteritis; vaccination.