Healthcare utilisation and related cost of care in the first two years related to RSV hospitalisation in infants born at 32 to 35 weeks gestation

Aim: Respiratory syncytial virus (RSV) lower respiratory tract infections (LRTIs) are associated with increased chronic respiratory morbidity in infants born prior to 32 weeks of gestation. Our aim was to determine if healthcare utilisation and related costs of care were increased in infants born between 32 and 35 weeks of gestation who had had an RSV LRTI hospitalisation. Methods: Healthcare utilisation in the first two years was assessed by examining the hospital and general practitioner records. The cost of care was calculated using the National Scheme of Reference costs and the British National Formulary prices. Three groups were compared: infants with at least one hospitalisation for an RSV LRTI (RSV), infants admitted for another respiratory problem (other respiratory) and infants admitted for a non respiratory problem/never been admitted (non respiratory). A principal components analysis was undertaken to account for any differences in the demographics between groups and a further generalised linear model was used to obtain adjusted estimates. Results: The mean total cost of care (minus the NICU admission) in the RSV group (£12,505) was greater than both that of the non respiratory (£1,178) and the other respiratory (£3,356) groups (p<0.0001). The adjusted mean differences in the cost of care was £11,116 between the RSV and non respiratory groups (p=0.001) and £9,076 between the RSV and the other respiratory groups (p=0.007). Conclusion: In infants born between 32-35 weeks of gestation, hospitalisation for an RSV LRTI was associated with significantly increased health related cost of care in the first two years after birth.