title: Impact of self-financed rotavirus vaccines on hospital stays and costs in Spain after a 3-year introductory period.
abstract: Vaccination has reduced rotavirus hospitalizations by 25% in European regions with low-moderate vaccine availability. We aimed to quantify the reduction in hospital costs after the longest period in which Rotarix® and Rotateq® were simultaneously commercially available in Spain. Cases, length of stay (LOS), and diagnosis-related groups (DRGs) were retrieved from the Minimum Basic Data Set. Healthcare expenditure was estimated through the cost accounting system Gescot®. DRGs were clustered: I, non-bacterial gastroenteritis with complications; II, without complications; III, requiring surgical/other procedures or neonatal cases (highest DRG weights). Comparisons between pre (2003-2005)- and post-vaccine (2007-2009) hospital stays and costs by DRG group were made. Rotaviruses were the most common agents of specific-coded gastroenteritis (N = 1657/5012). LOS and extended LOS of rotaviruses fell significantly in 2007-2009 (β-coefficient = -0·43, 95% confidence intervals (95% CI) -0·68 to -0·17; and odds ratio 0·62, 95% CI 0·50-0·76, respectively). Overall, costs attributable to rotavirus hospitalizations fell approximately €244 per patient (95% CI -365 to -123); the decrease in DRG group III was €2269 per patient (95% CI -4098 to -380). We concluded modest savings in hospital costs, largely attributable to cases with higher DRG weights, and a faster recovery. A universal rotavirus vaccination program deserves being re-evaluated, regarding its potential high impact on both at-risk children and societal costs.
authors.affiliation: Research Support Unit,La Mancha Centro General Hospital,Alcázar de San Juan, 13600 Ciudad Real,Spain.
authors.forename: O
authors.identifier: 0000-0003-0964-5668
authors.initials: O
authors.lastname: Redondo-González
authors.affiliation: Preventive Medicine Unit,Pare Jofré Hospital,46017 Valencia,Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Tenías-Burillo
authors.affiliation: Service of Economic Management Control, La Mancha Centro General Hospital,Alcázar de San Juan, 13600 Ciudad Real,Spain.
authors.forename: J
authors.initials: J
authors.lastname: Ruiz-Gonzalo
mesh_terms: D005759:Gastroenteritis / Q000145:classification / Q000191:economics / Q000517:prevention & control* / Q000821:virology; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data*; D012401:Rotavirus / Q000276:immunology*; D012400:Rotavirus Infections / Q000145:classification / Q000191:economics / Q000517:prevention & control* / Q000821:virology; D022243:Rotavirus Vaccines / Q000008:administration & dosage / Q000191:economics*; D013030:Spain; D014613:Vaccines, Attenuated / Q000008:administration & dosage / Q000191:economics
chemical_list: C492457:RIX4414 vaccine; C492535:RotaTeq; D022243:Rotavirus Vaccines; D014613:Vaccines, Attenuated
keywords: Hospital costs; Spain; length of stay; rotavirus; vaccines