PDF(Pubmed)
Abstract：
Morbidity and mortality caused by respiratory syncytial virus (RSV) in older adults and those with underlying health conditions can be potentially alleviated through vaccination. To assist vaccine policy decision-makers and payers, we estimated the annual economic burden of RSV-associated cardiorespiratory hospitalizations among insured US adults aged ≥18 y in the Merative MarketScan claims database from September through August of 2017-2018 and 2018-2019. Negative binomial regression models were used to estimate the number of RSV-associated cardiorespiratory hospitalizations using MarketScan-identified cardiorespiratory diagnosis codes in the presence or absence of RSV circulation per weekly laboratory test positivity percentages from the Centers for Disease Control and Prevention. This number was multiplied by mean cardiorespiratory hospitalization costs to estimate total costs for RSV-associated cardiorespiratory hospitalizations. Number and cost for International Classification of Diseases (ICD)-coded RSV hospitalizations were quantified from MarketScan. In 2017-2018 and 2018-2019, respectively, 18,515,878 and 16,462,120 adults with commercial or Medicare supplemental benefits were assessed. In 2017-2018, 301,248 cardiorespiratory hospitalizations were observed; 0.32% had RSV-specific ICD codes, costing $44,916,324, and 5.52% were RSV-associated cardiorespiratory hospitalizations, costing $734,078,602 (95% CI: $460,826,580-$1,103,358,799). In 2018-2019, 215,525 cardiorespiratory hospitalizations were observed; 0.34% had RSV-specific ICD codes, costing $33,053,105, and 3.14% were RSV-associated cardiorespiratory hospitalizations, costing $287,549,472 (95% CI: $173,377,778-$421,884,259). RSV contributes to substantial economic burden of cardiorespiratory hospitalizations among US adults. Modeling excess risk using viral positivity data provides a comprehensive estimation of RSV hospitalization burden and associated costs, compared with relying on ICD diagnosis codes alone.
摘要：
呼吸道合胞病毒（RSV）在老年人和有潜在健康状况的人群中引起的发病率和死亡率可以通过疫苗接种得到缓解。协助疫苗政策决策者和付款人，我们在MerativeMarketScan理赔数据库中估算了2017-2018年和2018-2019年9月至8月期间,年龄≥18岁的美国成年人与RSV相关的心肺住院治疗的年度经济负担.在疾病控制和预防中心每周实验室测试阳性百分比存在或不存在的情况下，使用MarketScan识别的心肺诊断代码，使用负二项回归模型来估计RSV相关心肺住院治疗的数量。将该数字乘以平均心肺住院费用，以估算RSV相关心肺住院费用的总费用。根据MarketScan对国际疾病分类(ICD)编码的RSV住院治疗的数量和成本进行量化。分别在2017-2018年和2018-2019年，评估了18,515,878和16,462,120名具有商业或Medicare补充福利的成年人。在2017-2018年，观察到301,248例心肺住院;0.32％具有RSV特异性ICD代码，RSV相关的心肺住院治疗费用为$44,916,324，5.52%，成本734078602美元（95%CI：460,826,580美元-1,103,358,799美元）。在2018-2019年，观察到215,525例心肺住院;0.34％具有RSV特异性ICD代码，RSV相关的心肺住院治疗费用为33,053,105美元，3.14%，成本为287549472美元（95%CI：17377778美元-42884259美元）。RSV对美国成年人的心肺住院治疗造成了巨大的经济负担。使用病毒阳性数据建模超额风险提供了RSV住院负担和相关成本的全面估计。与仅依靠ICD诊断代码相比。
