title: The hidden costs and characteristics of childhood rotavirus emergency visits in Canada.
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.
authors: Department of Pediatrics, Children's Hospital of Eastern Ontario and CHEO Research Institute, Ottawa, Ontario, Canada. lesaux@cheo.on.ca
authors: Nicole
authors: N
authors: Le Saux
authors: Julie
authors: J
authors: Bettinger
authors: Pierre
authors: P
authors: Déry
authors: Joanne
authors: J
authors: Embree
authors: Wendy
authors: W
authors: Vaudry
authors: Scott A
authors: SA
authors: Halperin
authors: Andrew
authors: A
authors: McDermid
authors: Timothy F
authors: TF
authors: Booth
authors: Doug
authors: D
authors: Coyle
mesh_terms: D002170:Canada / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000191:economics* / Q000706:statistics & numerical data*; D005243:Feces / Q000821:virology; D005260:Female; D005759:Gastroenteritis / Q000191:economics* / Q000453:epidemiology* / Q000821:virology; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D008297:Male; D012401:Rotavirus / Q000302:isolation & purification; D012400:Rotavirus Infections / Q000191:economics* / Q000453:epidemiology*