Institutional members access full text with Ovid®

Share this article on:

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††

The Pediatric Infectious Disease Journal: February 2012 - Volume 31 - Issue 2 - p 159–163
doi: 10.1097/INF.0b013e3182375011
Original Studies

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.

Supplemental Digital Content is available in the text.

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:

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

© 2012 Lippincott Williams & Wilkins, Inc.