title: Respiratory outcomes, utilization and costs 12 months following a respiratory syncytial virus diagnosis among commercially insured late-preterm infants.
abstract: OBJECTIVE
  To determine, among a commercially-insured population of late-preterm infants, utilization of healthcare resources and costs during the 1 year following a diagnosis of respiratory syncytial virus lower respiratory infection (RSV LRI).
  
  
  METHODS
  Administrative claims for non-capitated, commercially-insured infants <1 year old were used to identify infants diagnosed with RSV LRI and unspecified bronchiolitis/pneumonia (UBP). Infants were stratified by the setting of diagnosis. Infants without evidence of RSV LRI or UBP were selected as a comparison group. Economic and clinical outcomes were analyzed descriptively using propensity score weighting and logged ordinary least squares models were used to examine the relationship between RSV and costs (adjusted to 2006 USD) incurred within 1 year of RSV LRI.
  
  
  RESULTS
  The majority of infants were 3 months or older at the time of RSV LRI or UBP diagnosis. The rate of wheezing was significantly greater for infants in the RSV LRI and UBP cohorts relative to the comparison group (p < 0.001). Infantile asthma rates were 6-9 times higher among RSV LRI and UBP infants than the comparison group. RSV LRI and UBP infants also had significantly more emergency department visits and outpatient visits than the comparison group. The marginal healthcare costs were significantly higher for RSV LRI inpatients ($24,027) and outpatients ($2703) infants than for the comparison group (all p < 0.001).
  
  
  CONCLUSIONS
  Commercially insured late-preterm infants with RSV infection are at high risk for recurrent wheezing and infantile asthma during the 1-year period after the initial episode and impose a significant economic burden to the healthcare system.
authors.affiliation: Thomson Reuters, Outcomes Research, Washington, DC, USA.
authors.forename: Liisa
authors.initials: L
authors.lastname: Palmer
authors.forename: Caroline B
authors.initials: CB
authors.lastname: Hall
authors.forename: Julie P
authors.initials: JP
authors.lastname: Katkin
authors.forename: Nianwen
authors.initials: N
authors.lastname: Shi
authors.forename: Anthony S
authors.initials: AS
authors.lastname: Masaquel
authors.forename: Kimmie K
authors.initials: KK
authors.lastname: McLaurin
authors.forename: Parthiv J
authors.initials: PJ
authors.lastname: Mahadevia
mesh_terms: D000465:Algorithms; D015331:Cohort Studies; D003132:Commerce; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000191:economics* / Q000628:therapy*; D019458:Insurance Coverage / Q000191:economics* / Q000706:statistics & numerical data; D007363:Intensive Care Units, Neonatal / Q000191:economics / Q000706:statistics & numerical data; D008297:Male; D012119:Respiration; D018357:Respiratory Syncytial Virus Infections / Q000151:congenital / Q000175:diagnosis / Q000191:economics* / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome