ORIGINAL ARTICLE

Health care utilisation of prematurely born, preschool children related to hospitalisation for RSV infection

A Greenough¹, J Alexander², S Burgess³, J Bytham¹, P A J Chetcuti³, J Hagan⁴, W Lenney², S Melville², N J Shaw⁴, J Boorman⁵, S Coles⁵, J Turner⁶, F Pang⁵

¹ King’s College Hospital, London, UK
² North Staffordshire Hospital, Stoke-on-Trent, UK
³ Leeds General Infirmary, UK
⁴ Liverpool Women’s Hospital, UK
⁵ Abbott Laboratories Ltd, Maidenhead, UK
⁶ Therapeutic Management, Crowthorne, UK

Correspondence to:
Correspondence to:
Professor A Greenough
Dept of Child Health, King’s College Hospital, London SE5 9RS, UK; anne.greenough{at}kcl.ac.uk

Background: In prematurely born infants with chronic lung disease (CLD), RSV hospitalisation is associated with increased health service utilisation and costs in the first two years after birth.

Aims: To determine whether RSV hospitalisation in the first two years was associated with chronic respiratory morbidity during the preschool years in prematurely born children who had had CLD.

Methods: Retrospective review of readmissions, outpatient attendances, and community care in years 2–4 and, at age 5 years, assessment of the children’s respiratory status and their health related quality of life. Comparison was made of the results of children who had had at least one hospitalisation in the first two years after birth for RSV infection (RSV group) to those of the rest of the cohort. Participants were 190 of an original cohort of 235 infants with CLD and a median gestational age 27 (range 22–33) weeks.

Results: The 33 children in the RSV group, compared to the rest of the cohort, had a greater duration of hospital stay and more outpatient appointments. The RSV group had required more prescriptions for all treatments and respiratory medications, and more had used an inhaler. The cost of care of the RSV group was higher (median £2630 [4000, US$4800], range £124–18 091 versus £1360 [2500, US$3000], range £5–18 929) and their health related quality of life was lower.

Conclusion: In prematurely born children who had developed CLD, RSV hospitalisation in the first two years was associated with chronic respiratory morbidity and increased cost of care.

Abbreviations: CLD, chronic lung disease; CPAP, continuous positive airway pressure; HDU, high dependency unit; HUI, Health Utility Index; ICU, intensive care unit; IPPV, intermittent positive pressure ventilation; NICU, neonatal intensive care unit; PDA, patent ductus arteriosus; RSV, respiratory syncytial virus

Keywords: RSV; prematurity; chronic lung disease

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