Identifying High-Cost RSV Hospitalizations at a Secondary Hospital in Japan

Area of Science:

• Pediatrics
• Infectious Diseases
• Health Economics

Background:

• Respiratory syncytial virus (RSV) is a major cause of infant hospitalization globally.
• Data on RSV healthcare costs in secondary hospitals are limited.
• Understanding these costs is crucial for resource allocation and public health planning.

Purpose of the Study:

• To analyze RSV-related hospitalization costs in a Japanese secondary hospital.
• To identify factors contributing to high-cost RSV cases.
• To inform potential improvements in prophylaxis and intervention strategies.

Main Methods:

• Retrospective analysis of 345 laboratory-confirmed RSV hospitalizations from April 2018 to May 2024.
• Division of the study period into three phases based on medical reimbursement schedule revisions.
• Calculation of hospitalization costs and identification of cost outliers using the IQR method.

Main Results:

• Median hospitalization costs per episode increased across the study phases (JPY 318,930 to JPY 393,930).
• Eighteen high-cost outlier admissions were identified.
• Outliers included children with airway/neurologic disorders, healthy infants under 12 months, and those outside palivizumab eligibility periods.

Conclusions:

• High-cost RSV cases extend beyond currently defined high-risk groups.
• Older children with chronic airway disease and healthy young infants represent significant cost burdens.
• Refining prophylaxis and early intervention strategies in Japan could reduce clinical burden and healthcare costs.