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The Hidden Costs and Characteristics of Childhood Rotavirus Emergency Visits in Canada

Le Saux, Nicole MD*; Bettinger, Julie PhD; Déry, Pierre MD; Embree, Joanne MD§; Vaudry, Wendy MD; Halperin, Scott A. MD; McDermid, Andrew BSc**; Booth, Timothy F. PhD**; Coyle, Doug PhD††

Pediatric Infectious Disease Journal:
doi: 10.1097/INF.0b013e3182375011
Original Studies
Abstract

Background: Administrative databases are often used to determine burden of rotavirus disease in emergency departments (EDs). Our objective was to describe rotavirus ED visits to include healthcare utilization pre- and postvisit to estimate true societal costs.

Methods: During rotavirus seasons in 2007, 2008, and 2009, a convenience sample of children <3 years of age with vomiting and/or diarrhea and rotavirus in stool samples at ED visits was identified at 5 pediatric hospitals in Canada. Interviews took place within 24 hours and 2 weeks after diagnosis, and ED charts were reviewed. Using unit costs for all resources, healthcare and societal costs were determined in Canadian dollars.

Results: A total of 199 children (mean age, 16 months; range, 1–35 months) had rotavirus and had a completed initial questionnaire on record. Prior healthcare provider visits had occurred in 104 (52.3%) before and 50/172 (29.1%) children 2 weeks after the ED visit. The mean healthcare cost of the ED visit alone was $218.10 (95% confidence interval [CI]: $198, $238), and the mean societal cost was $261.40 (95% CI: $240, $283). Including both total healthcare and parental costs, this increased to a mean total societal cost of $674.80 (95% CI: $578, $771) per episode of rotavirus infection.

Conclusions: Both the pre- and postvisit costs contribute substantially to the societal costs associated with an ED visit for rotavirus infection. In Canada, we estimate that the annual healthcare cost for children requiring a rotavirus ED visit ranges from $4.5 to $9.3 million, but when parental costs are included, the total societal cost ranges from $8.9 to $18.4 million.

Author Information

From the *Department of Pediatrics, Children's Hospital of Eastern Ontario and CHEO Research Institute, Ottawa, Ontario, Canada; †Vaccine Evaluation Center, BC Children's Hospital and the University of British Columbia, Vancouver, BC, Canada; ‡Centre Mère-Enfant de Québec (CHUL) and Université Laval, Québec, Québec, Canada; §Department of Pediatrics, Winnipeg Children's Hospital and the University of Manitoba, Winnipeg, Manitoba, Canada; ¶Department of Pediatrics, Stollery Children's Hospital and University of Alberta, Edmonton, Alberta, Canada; ∥Canadian Center for Vaccinology, IWK Health Center and Dalhousie University, Halifax, Nova Scotia, Canada; **National Microbiology Laboratory, Winnipeg, Manitoba, Canada; and ††Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada.

Accepted for publication September 12, 2011.

This study was supported by a grant from GlaxoSmithKline Inc., Merck Frosst Canada Ltd, and the Public Health Agency of Canada. The authors have no other funding or conflicts of interest to disclose.

Address for correspondence: Nicole Le Saux, MD, FRCP(C), Division of Infectious Diseases, Children's Hospital of Eastern Ontario, 401 Smyth Rd, Ottawa, Ontario K1S 3C4, Canada. E-mail: lesaux@cheo.on.ca.

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© 2012 Lippincott Williams & Wilkins, Inc.