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Published on: December 10, 2013
RSV Burden and Its Impact on Pediatric Inpatient Bed Occupancy in Belgium: An Analysis of National Hospital Claims
Nicolas Bouckaert1, Mélanie Lefèvre, Koen Van den Heede
1From the Belgian Health Care Knowledge Centre (KCE), Kruidtuinlaan, Brussels, Belgium.
Insights
Respiratory syncytial virus (RSV) significantly impacts pediatric hospital bed capacity, causing overcrowding during peak winter months. Strategies like RSV immunization and regional collaboration can reduce this burden.
Area of Science:
- Pediatric hospital management
- Infectious disease epidemiology
- Healthcare resource utilization
Background:
- Respiratory syncytial virus (RSV) infections pose a significant burden on pediatric hospital services, particularly during winter.
- While morbidity and financial costs are known, the organizational impact on hospital capacity and overcrowding is less understood.
- Understanding the impact on bed capacity and inter-hospital variations is crucial for effective resource allocation.
Purpose of the Study:
- To analyze the organizational impact of RSV hospitalizations on pediatric bed capacity and occupancy rates.
- To investigate variations in hospital bed occupancy across different pediatric services.
- To assess the impact of RSV on hospital overcrowding and identify potential mitigation strategies.
Main Methods:
- Retrospective analysis of Belgian Hospital Discharge Data Set for 2017-2018.
- Inclusion of all RSV-associated and all-cause acute hospitalizations in pediatric wards for children under 5.
- Analysis of bed occupancy rates, including peak periods and daily fluctuations.
Main Results:
- RSV hospitalizations account for substantial bed occupancy (20%-40%) during peak season (Nov-Dec).
- Mean annual bed occupancy varies widely (22.8%-95.1%), with smaller services being more vulnerable.
- 46 hospital sites exceeded 100% daily occupancy for a median of 9 days.
Conclusions:
- Pediatric services are often over-dimensioned to manage RSV peaks.
- RSV immunization can significantly decrease pediatric capacity needs.
- Enhanced regional collaboration offers a strategy to manage peaks and reduce capacity requirements.
Background:
Respiratory syncytial virus (RSV) infections represent a substantial burden on pediatric services during winter. While the morbidity and financial burden of RSV are well studied, less is known about the organizational impact on hospital services (ie, impact on bed capacity and overcrowding and variation across hospitals).
Methods:
Retrospective analysis of the population-wide Belgian Hospital Discharge Data Set for the years 2017 and 2018 (including all hospital sites with pediatric inpatient services), covering all RSV-associated (RSV-related International Classification of Diseases, 10th Version, Clinical Modification diagnoses) inpatient hospitalization by children under 5 years old as well as all-cause acute hospitalizations in pediatric wards.
Results:
RSV hospitalizations amount to 68.3 hospitalizations per 1000 children less than 1 year and 5.0 per 1000 children 1-4 years of age and are responsible for 20%-40% of occupied beds during the peak period (November-December). The mean bed occupancy rate over the entire year (2018) varies across hospitals from 22.8% to 85.1% and from 30.4% to 95.1% during the peak period. Small-scale pediatric services (<25 beds) are more vulnerable to the volatility of occupancy rates. Forty-six hospital sites have daily occupancy rates above 100% (median of 9 days). Only in 1 of 23 geographically defined hospital networks these high occupancy rates are on the same calendar days.
Conclusions:
Pediatric services tend to be over-dimensioned to deal with peak activity mainly attributable to RSV. RSV immunization can substantially reduce pediatric capacity requirements. Enhanced collaboration in regional networks is an alternative strategy to deal with peaks and reduce capacity needs.
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