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Published on: August 24, 2011
A method for identifying the financial burden of hospitalized infants on families
Shelah Leader1, Phillip Jacobson, James Marcin
1MedImmune Inc., 35 West Watkins Mill Road, Gaithersburg, MD 20878, USA. Leaders@medimmune.com
Insights
This study presents a method to measure family costs associated with infant respiratory syncytial virus (RSV) hospitalization. The findings highlight significant financial and time burdens extending beyond the hospital stay.
Area of Science:
- Pediatric Health Economics
- Infectious Disease Research
- Family Impact Studies
Background:
- Infant hospitalization for respiratory syncytial virus (RSV) incurs significant family costs.
- Existing methods may not fully capture the direct and indirect financial burdens on families.
- Understanding these costs is crucial for comprehensive healthcare support and policy development.
Purpose of the Study:
- To develop and describe a robust methodology for quantifying the direct and indirect costs experienced by families of infants hospitalized with RSV.
- To identify previously unreported financial and time-related burdens associated with infant RSV hospitalizations.
Main Methods:
- A prospective survey utilizing a pretested questionnaire was administered to caregivers of hospitalized infants (<12 months) with confirmed RSV.
- Face-to-face interviews were conducted on discharge, followed by telephone interviews one month later to capture all costs.
- The study included infants who had not received RSV prophylaxis and were hospitalized in tertiary-care centers.
Main Results:
- The survey captured costs beyond direct parental expenses, including non-parental work absences for visits and sibling care by volunteers.
- Follow-up interviews revealed that out-of-pocket expenses and missed work continued for a month post-discharge.
- Relying solely on closed-ended questions would have omitted critical cost data.
Conclusions:
- Survey instruments require pretesting and should incorporate open-ended questions to capture unanticipated costs.
- Probing respondents for details is essential for accurate cost assessment.
- This methodology effectively identified significant, previously underreported time and financial burdens on families during and after infant RSV hospitalization.
Objectives:
To describe a method for measuring the direct and indirect costs to families of infants hospitalized with respiratory syncytial virus (RSV).
Methods:
After pretesting and revising a questionnaire, a prospective survey was conducted in multiple tertiary-care hospitals with pediatric intensive care units. Eligible patients were infants less than 12 months old who had not received RSV prophylaxis and were hospitalized with a confirmed RSV infection. All English- and Spanish-speaking caregivers of eligible subjects were asked to participate in a face-to-face, structured interview on the day of hospital discharge regarding hospitalization-related direct and indirect costs. Thirty days later, caregivers were re-interviewed by telephone about their RSV-related costs during the elapsed month. The survey was initiated in February 2000 and continued through April 2001.
Results:
In addition to the infants' parents, numerous adults visited 55% of hospitalized infants. In 17% of cases, nonparents missed work to visit the child. Volunteers watched siblings of 26% of the infants. Relying only on closed-ended questions about parents' costs during the hospitalization would have missed important information about child-care volunteers and types of expenses. Follow-up interviews revealed that RSV-related out-of-pocket expenses and missed work continued during the month following discharge.
Conclusions:
Survey instruments should be pretested with potentially eligible subjects. Open-ended questions are needed, because all costs cannot be anticipated. Respondents should be probed for details. This method revealed certain time and financial burdens during and after hospitalization that had not been previously reported in the literature.
