Nonmedical costs associated with rotavirus disease requiring hospitalization.
BACKGROUND
As the most common cause of severe diarrhea among children, rotavirus has a significant economic impact. Previous studies focused on the direct medical costs of rotavirus infections; however, nonmedical costs account for the majority of the financial burden from this disease. Herein, we report the results from the largest prospective study in the United States determining the nonmedical costs of severe rotavirus infections.


METHODS
Prospective, active, gastroenteritis case surveillance was conducted between November 1997 and December 1999 at 3 pediatric medical centers. Rotavirus infection was identified for 548 children admitted between 2 weeks and 5 years of age. Detailed information about nonmedical costs during the prehospitalization, hospitalization and posthospitalization periods was obtained through interviews.


RESULTS
The average nonmedical cost per case of rotavirus disease was USD $448.77, including $359.04 for missed work, $56.66 for transportation, $11.90 for oral rehydration solutions, $9.59 for diapers, $6.83 for child care changes, $3.82 for special foods and $0.93 for formula changes. More than one-half of these expenses (53%) occurred outside the hospitalization period, and 80% of the cost was attributable to missed work.


CONCLUSIONS
With an estimated 50,000 hospitalizations attributable to rotavirus each year in the United States, the nonmedical costs of severe rotavirus infections may exceed USD $22 million annually. Previous cost effectiveness analyses of rotavirus vaccines substantially underestimated this burden, suggesting that the nonmedical costs associated with mild to moderate rotavirus disease have been similarly underestimated. These findings are needed to assess accurately the cost effectiveness of future rotavirus immunization strategies.
Lee
Brian P
BP
Children's Hospital and Research Center at Oakland, Oakland, CA, USA. blee@mail.cho.org
Azimi
Parvin H
PH
Staat
Mary Allen
MA
Louie
Leslie
L
Parada
Ester
E
Berke
Tamas
T
Ward
Richard L
RL
Bernstein
David I
DI
Matson
David O
DO
D000956:Antigens, Viral / Q000032:analysis; D002675:Child, Preschool; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003365:Costs and Cost Analysis; D005243:Feces / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000191:economics* / Q000517:prevention & control / Q000821:virology; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D012401:Rotavirus / Q000276:immunology; D012400:Rotavirus Infections / Q000191:economics* / Q000517:prevention & control*; D022243:Rotavirus Vaccines / Q000191:economics*; D014186:Transportation / Q000191:economics; D014481:United States; D014937:Work / Q000191:economics
D000956:Antigens, Viral; D022243:Rotavirus Vaccines