title: Viral lower respiratory tract infections and preterm infants' healthcare utilisation.
abstract: The aim of this study was to determine whether respiratory syncytial virus (RSV) and other viral lower respiratory tract infections (LRTI) in prematurely born infants were associated with similar effects on healthcare utilisation and related cost of care in the second compared to the first year after birth. Thirteen infants who had RSV LRTIs (RSV), 21 who had other viral LRTIs (other viral) and 25 had no viral LRTIs (no LRTI) were prospectively followed. Nasopharyngeal aspirates were collected whenever an infant had an LRTI regardless of whether it was in the hospital or in the community. Healthcare utilisation and the health-related cost of care were determined. Only the RSV group compared to the no LRTI group had higher overall respiratory costs in both year 1 (mean, £3,917 versus £24; p < 0.041) and year 2 (mean, £1,164 versus £61; p = 0.012). Only the RSV group required respiratory admissions; the RSV admission rate in year 2 was 3.4 % (number needed to treat 59).
  
  
  CONCLUSIONS
  RSV LRTIs are associated with increased healthcare utilisation and cost of care in the first and second year; nevertheless, if prophylaxis is to be cost-effective in the second year, a high risk group needs to be identified.
authors.affiliation: Division of Asthma, Allergy and Lung Biology, MRC-Asthma UK Centre in Allergic Mechanisms of Asthma, King's College London, London, UK, simon.drysdale@kcl.ac.uk.
authors.forename: Simon B
authors.initials: SB
authors.lastname: Drysdale
authors.forename: Mireia
authors.initials: M
authors.lastname: Alcazar-Paris
authors.forename: Theresa
authors.initials: T
authors.lastname: Wilson
authors.forename: Melvyn
authors.initials: M
authors.lastname: Smith
authors.forename: Mark
authors.initials: M
authors.lastname: Zuckerman
authors.forename: Janet L
authors.initials: JL
authors.lastname: Peacock
authors.forename: Sebastian L
authors.initials: SL
authors.lastname: Johnston
authors.forename: Anne
authors.initials: A
authors.lastname: Greenough
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000191:economics / Q000627:therapeutic use; D000998:Antiviral Agents / Q000191:economics / Q000627:therapeutic use; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D017048:Health Care Costs; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology; D000069455:Palivizumab; D010342:Patient Acceptance of Health Care; D011446:Prospective Studies; D018357:Respiratory Syncytial Virus Infections / Q000191:economics / Q000628:therapy* / Q000821:virology; D012141:Respiratory Tract Infections / Q000191:economics / Q000628:therapy* / Q000821:virology
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000998:Antiviral Agents; D000069455:Palivizumab